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Individual

JENNIFER LYNN IRVING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-2000
(401) 456-2282
Mailing address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-2000
(401) 456-2282

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00536
RI

Other

Enumeration date
10/15/2008
Last updated
09/27/2011
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