Provider Demographics
NPI:1295994069
Name:COCCHIARELLA, NANCY J (CRNP)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:J
Last Name:COCCHIARELLA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:J
Other - Last Name:ZONFRILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:297 PROMENADE ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-5720
Mailing Address - Country:US
Mailing Address - Phone:401-491-6464
Mailing Address - Fax:401-490-6463
Practice Address - Street 1:297 PROMENADE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-5720
Practice Address - Country:US
Practice Address - Phone:401-491-6464
Practice Address - Fax:401-490-6463
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN00669363LW0102X
PASP009631363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner