Most Relevant Information
Provider Data
| NPI Number: | 1003522251 |
| Provider Name: | ELIZABETH MOORE MEDBURY APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | APRN03461 |
Most Important Dates
| Enumeration Date: | 01/30/2023 |
| Last Updated: | 01/30/2023 |
Provider Practice Location
830 CHALKSTONE AVE
PROVIDENCE
RI
029084734
Practice Location Phone/Fax
| Phone: | 4012737011 |
| Fax: |
Provider Mailing Location
830 CHALKSTONE AVE
PROVIDENCE
RI
029084734
Provider Mailing Phone/Fax
| Phone: | 4012737011 |
| Fax: |