Provider Demographics
NPI:1578262903
Name:ROY, CARRIE A (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:A
Last Name:ROY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:A
Other - Last Name:ROSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2178 MENDON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-3846
Mailing Address - Country:US
Mailing Address - Phone:401-333-5201
Mailing Address - Fax:401-333-5215
Practice Address - Street 1:2178 MENDON RD STE 100
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-3846
Practice Address - Country:US
Practice Address - Phone:401-333-5201
Practice Address - Fax:401-333-5215
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN03716208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA