Provider Demographics
NPI:1710089883
Name:POIRIER-WOOLF, MICHELINE LISE (NPP)
Entity Type:Individual
Prefix:MS
First Name:MICHELINE
Middle Name:LISE
Last Name:POIRIER-WOOLF
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 MACINTOSH LN
Mailing Address - Street 2:
Mailing Address - City:SAUNDERSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02874-1938
Mailing Address - Country:US
Mailing Address - Phone:401-294-7054
Mailing Address - Fax:401-732-2763
Practice Address - Street 1:400 BALD HILL RD STE 511
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-6100
Practice Address - Country:US
Practice Address - Phone:401-738-8100
Practice Address - Fax:401-732-2763
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP30927363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI30599-2OtherBCBS
RINPP30927OtherNURSE PRACTITIONER LICENS
RI404468OtherBCHIP
RINPP30927OtherNURSE PRACTITIONER LICENS