Individual
DR. MARY JO M MACKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, ND
Contact information
Practice address
8 ABBOTT PARK PL, PROVIDENCE, RI 02903-3703
(401) 598-1104
Mailing address
68 WOOD COVE DR, COVENTRY, RI 02816-6611
(303) 981-4407
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
259166
MA
363L00000X
Nurse Practitioner
Primary
APRN00581
RI
Other
Enumeration date
03/22/2007
Last updated
12/04/2018
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