Individual
MICAH SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-BC
Contact information
Practice address
475 KILVERT ST, WARWICK, RI 02886-1379
(401) 256-1967
Mailing address
69 HIGH ST, PLAINVILLE, MA 02762-1801
(774) 306-1630
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN01665
RI
Other
Enumeration date
08/30/2017
Last updated
04/30/2019
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