Provider Demographics
NPI:1508118811
Name:MCGRATH, ANNE MARIE (PNP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CENTERVILLE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-0200
Mailing Address - Country:US
Mailing Address - Phone:401-615-2299
Mailing Address - Fax:401-615-7529
Practice Address - Street 1:300 CENTERVILLE RD STE 110
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-0200
Practice Address - Country:US
Practice Address - Phone:401-615-2299
Practice Address - Fax:401-615-7529
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN03390363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIAPRN03390OtherLICENSE