Individual
KATHERINE P OBARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1085 N MAIN ST, PROVIDENCE, RI 02904-5719
(401) 415-4200
Mailing address
1085 N MAIN ST, PROVIDENCE, RI 02904-5719
(401) 415-4200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN00642
RI
363LG0600X
Gerontology Nurse Practitioner
APRN00642
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002669101
MEDICARE
—
01
—
709003943
MEDICARE GROUP PTAN
RI
05
—
KO88278
—
RI
Enumeration date
08/10/2010
Last updated
11/25/2025
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