Individual
MS. SUNNY XAYACHACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
66 PAVILION AVE, PROVIDENCE, RI 02905-1522
(401) 461-9110
Mailing address
66 PAVILION AVE, PROVIDENCE, RI 02905-1522
(401) 461-9110
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN11525
RI
Other
Enumeration date
03/18/2022
Last updated
03/18/2022
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