Williams, Modupe O

Williams, Modupe O is an sole proprietor health care provider with primary practice located at 1 Kristen Dr , North Providence RI 02911-2932. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Williams, Modupe O can be contacted via phone (401) 447-8569.

Contact Information

Primary practice address
1 Kristen Dr North Providence RI 02911-2932
Phone: (401) 447-8569
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN2319054 Massachusetts

Profile Details

NPI number 1265943724
LBN Legal business name Williams, Modupe O
Credentials NP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 23rd, 2017
Last updated Oct 23rd, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265943724 NPPES
Massachusetts MEDICAID 12345676289
Massachusetts MEDICAID 12345676289

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