Provider Demographics
NPI:1457891483
Name:WOS, RENATA (APRN)
Entity Type:Individual
Prefix:
First Name:RENATA
Middle Name:
Last Name:WOS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 SMITHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-6285
Mailing Address - Country:US
Mailing Address - Phone:401-338-7772
Mailing Address - Fax:401-724-0896
Practice Address - Street 1:525 BROAD ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864
Practice Address - Country:US
Practice Address - Phone:401-338-7772
Practice Address - Fax:401-724-0896
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN01526363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health