Provider Demographics
NPI:1598954000
Name:HULL, MABEL DIANNE (RN)
Entity Type:Individual
Prefix:MS
First Name:MABEL
Middle Name:DIANNE
Last Name:HULL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:MABEL
Other - Middle Name:DIANNE
Other - Last Name:LOUIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:43 CLEMATIS ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-4109
Mailing Address - Country:US
Mailing Address - Phone:401-654-6026
Mailing Address - Fax:
Practice Address - Street 1:830 CHALKSTONE AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-4734
Practice Address - Country:US
Practice Address - Phone:401-273-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-20
Last Update Date:2007-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN44196163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse