Individual
MARY-KATE P EARLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
Mailing address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6346
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN53556
RI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN02426
RI
Other
Enumeration date
03/22/2020
Last updated
07/23/2021
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