Provider Demographics
NPI:1558455006
Name:MORIN, ETHEL MARIE (RN, CDE, CDOE)
Entity Type:Individual
Prefix:
First Name:ETHEL
Middle Name:MARIE
Last Name:MORIN
Suffix:
Gender:F
Credentials:RN, CDE, CDOE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 QUAKER HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:UXBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01569
Mailing Address - Country:US
Mailing Address - Phone:508-278-4344
Mailing Address - Fax:
Practice Address - Street 1:186 CASS AVE
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895
Practice Address - Country:US
Practice Address - Phone:401-769-9355
Practice Address - Fax:401-765-1721
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN25434163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI406764OtherBLUE CHIP
RI31282-4OtherBLUE CROSS/ BLUE SHIELD
RI6300126OtherUNITED HEALTH CARE