Individual
MARIAN E IDAHOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1054 CASS AVE, WOONSOCKET, RI 02895-4935
(866) 389-2727
Mailing address
1054 CASS AVENUE, WOONSOCKET, RI 02895-5947
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN01982
RI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN49908
RI
Other
Enumeration date
12/16/2018
Last updated
02/16/2025
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