Individual
CHARLIE IMONAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
39 EAST AVE, PAWTUCKET, RI 02860-4003
(401) 722-0081
(401) 312-0318
Mailing address
39 EAST AVE, PAWTUCKET, RI 02860-4003
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NPP37898
RI
Other
Enumeration date
08/15/2014
Last updated
12/06/2014
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