Provider Demographics
NPI:1972032530
Name:WETZEL, ABIGAIL PATRICIA (FNP-C, CNM)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:PATRICIA
Last Name:WETZEL
Suffix:
Gender:F
Credentials:FNP-C, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5301
Mailing Address - Country:US
Mailing Address - Phone:401-727-4800
Mailing Address - Fax:401-726-1514
Practice Address - Street 1:21 DIVISION ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860
Practice Address - Country:US
Practice Address - Phone:401-727-4800
Practice Address - Fax:401-726-1514
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICNM00164367A00000X
RIAPRN01617363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife