Provider Demographics
NPI:1407533136
Name:DUFFY, REBECCA (CPD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:DUFFY
Suffix:
Gender:F
Credentials:CPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 LELAND AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-5405
Mailing Address - Country:US
Mailing Address - Phone:401-250-2682
Mailing Address - Fax:
Practice Address - Street 1:25 LELAND AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-5405
Practice Address - Country:US
Practice Address - Phone:401-250-2682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-04
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI201538374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula