Provider Demographics
NPI:1396521852
Name:MCADAMS, MITCHELL (RN)
Entity type:Individual
Prefix:
First Name:MITCHELL
Middle Name:
Last Name:MCADAMS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PENROD AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-3313
Mailing Address - Country:US
Mailing Address - Phone:401-632-5894
Mailing Address - Fax:
Practice Address - Street 1:101 BACON ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5542
Practice Address - Country:US
Practice Address - Phone:401-722-3560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN76825163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse