Individual
MS. DIANE LESLIE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCNS
Contact information
Practice address
DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, MHBSS, 830 CHALKSTONE AVENUE, PROVIDENCE, RI 02908-4799
(401) 273-7100
(401) 457-3371
Mailing address
79 LAKESIDE AVENUE, CRANSTON, RI 02910-2314
(401) 781-0085
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26915
RI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
PPNS00060
RI
Other
Enumeration date
04/18/2006
Last updated
12/06/2011
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