Individual
KAYLA M ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
621 POUND HILL RD STE 104, NORTH SMITHFIELD, RI 02896-9358
(401) 769-6323
Mailing address
891 WESTMINSTER ST, PROVIDENCE, RI 02903-4020
(401) 331-7850
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODTG00679
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BC00404662
BLUE CROSS BLUE SHIELD OF RI
RI
Enumeration date
06/12/2019
Last updated
11/27/2023
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