Provider Demographics
NPI:1598306383
Name:DIROSARIO, RACHEL MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:DIROSARIO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BULLOCKS POINT AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-5351
Mailing Address - Country:US
Mailing Address - Phone:401-437-1008
Mailing Address - Fax:
Practice Address - Street 1:100 BULLOCKS POINT AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-5351
Practice Address - Country:US
Practice Address - Phone:401-437-1008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH075168-21163WM0705X
MARN2333004363LF0000X
RIAPRN02222363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical