Provider Demographics
NPI:1902821770
Name:FITTRO, MARSHA (RN)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:FITTRO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 WAMPANOAG TRL
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-2206
Mailing Address - Country:US
Mailing Address - Phone:401-435-5128
Mailing Address - Fax:401-270-4704
Practice Address - Street 1:184 WAMPANOAG TRL
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-2206
Practice Address - Country:US
Practice Address - Phone:401-435-5128
Practice Address - Fax:401-270-4704
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI14926163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI11450254OtherUNITED HEALTHCARE OF RI
RI29238-2OtherBCBSRI
RI30333OtherNEIGHBORHOOD HEALTH