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JACKIE MARLENE WOODSIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
51 OLD MILL RD, CHARLESTOWN, RI 02813-3322
(401) 364-1268
Mailing address
51 OLD MILL RD, CHARLESTOWN, RI 02813-3322
(401) 364-1268

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN04100
RI
390200000X
Student in an Organized Health Care Education/Training Program
RN58926
RI

Other

Enumeration date
01/25/2023
Last updated
07/31/2024
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