1114024643 NPI number — DR. PATRICIA A. CUNNINGHAM-WARBURTON APRN, PH.D.

Table of content: DR. PATRICIA A. CUNNINGHAM-WARBURTON APRN, PH.D. (NPI 1114024643)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114024643 NPI number — DR. PATRICIA A. CUNNINGHAM-WARBURTON APRN, PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CUNNINGHAM-WARBURTON
Provider First Name:
PATRICIA
Provider Middle Name:
A.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
APRN, PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WARBURTON
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1114024643
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/05/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1130 TEN ROD RD.
Provider Second Line Business Mailing Address:
SUITE E204
Provider Business Mailing Address City Name:
NORTH KINGSTOWN
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02852
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-294-9600
Provider Business Mailing Address Fax Number:
401-295-7395

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1130 TEN ROD RD
Provider Second Line Business Practice Location Address:
SUITE E204; THE MEADOWS
Provider Business Practice Location Address City Name:
NORTH KINGSTOWN
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02852
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-294-9600
Provider Business Practice Location Address Fax Number:
401-295-7395
Provider Enumeration Date:
09/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WP0808X , with the licence number:  RN 13078 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1114024643 . This is a "UNITEDHEALTHCARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 1114024643 . This is a "BLUE CROSS BLUE SHIELD OF RHODE ISLAND" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 1114024643 . This is a "TRICARE NORTH/SOUTH" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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