Provider Demographics
NPI:1407371453
Name:O'CONNOR, CARA ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:ANNE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:982 TIOGUE AVE
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-6116
Mailing Address - Country:US
Mailing Address - Phone:401-821-6800
Mailing Address - Fax:401-821-8513
Practice Address - Street 1:982 TIOGUE AVE
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816-6116
Practice Address - Country:US
Practice Address - Phone:401-821-6800
Practice Address - Fax:401-821-8513
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN01567363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily