Individual
ELIZABETH BLACK SHORTSLEEVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
279 NORTH ST, MEDFIELD, MA 02052-1211
(401) 258-2551
(855) 643-5020
Mailing address
475 KILVERT ST, WARWICK, RI 02886-1379
(401) 258-2551
(855) 643-5020
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NPP37637
RI
363LF0000X
Family Nurse Practitioner
RN2264330
MA
Other
Enumeration date
09/26/2011
Last updated
07/07/2014
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