Individual
IRACENA S LOPES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
900 WARREN AVE STE 302, EAST PROVIDENCE, RI 02914-1430
(800) 508-4908
(401) 490-5505
Mailing address
10 DAVOL SQ STE 400, PROVIDENCE, RI 02903-4760
(401) 421-4000
(401) 272-1456
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN01010
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801205521
—
RI
Enumeration date
08/06/2014
Last updated
02/03/2021
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