Provider Demographics
NPI:1407337322
Name:PLACE, MAUREEN ANGELA (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ANGELA
Last Name:PLACE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:A
Other - Last Name:PLACE DOWNIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:11 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-3569
Mailing Address - Country:US
Mailing Address - Phone:401-783-3384
Mailing Address - Fax:
Practice Address - Street 1:11 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-3569
Practice Address - Country:US
Practice Address - Phone:401-783-3384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI01901207Q00000X
RIAPRN01901363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine