Provider Demographics
NPI:1013644855
Name:NASCIMENTO, RILEY NICOLE (PA-C)
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:NICOLE
Last Name:NASCIMENTO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:MA
Mailing Address - Zip Code:02726-5818
Mailing Address - Country:US
Mailing Address - Phone:508-493-4250
Mailing Address - Fax:
Practice Address - Street 1:857 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-3360
Practice Address - Country:US
Practice Address - Phone:401-467-3115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant