Individual
MISS TESSA JUDE CENTRACCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-6195
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
(401) 444-6779
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
363LP0200X
RI
Other
Enumeration date
02/10/2021
Last updated
01/03/2023
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