Provider Demographics
NPI:1255387189
Name:PARDY, JANET TROTTA (NP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:TROTTA
Last Name:PARDY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 EDDY STREET MPH 131
Mailing Address - Street 2:RHODE ISLAND HOSPITAL
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903
Mailing Address - Country:US
Mailing Address - Phone:401-444-3421
Mailing Address - Fax:401-444-6378
Practice Address - Street 1:593 EDDY STREET MPH 131
Practice Address - Street 2:RHODE ISLAND HOSPITAL
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903
Practice Address - Country:US
Practice Address - Phone:401-444-3421
Practice Address - Fax:401-444-6378
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI37220363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIJT53630Medicaid
RINPP37220OtherLICENSE
RI007056503Medicare ID - Type Unspecified
RIJT53630Medicaid