Individual
ANGELA CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
900 WARREN AVE, SUITE 400, E PROVIDENCE, RI 02914-1430
(401) 331-1221
(401) 751-8003
Mailing address
10 DAVOL SQ, SUITE 400, PROVIDENCE, RI 02903-4754
(401) 421-4000
(401) 272-1456
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00143
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
709003711
GROUP MEDICARE
RI
05
—
9094118
—
RI
Enumeration date
09/30/2005
Last updated
04/02/2024
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