Provider Demographics
NPI:1669222956
Name:CARDARELLI, KATHRYN JULIETTE (RN)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:JULIETTE
Last Name:CARDARELLI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 FALCON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:RI
Mailing Address - Zip Code:02822-2406
Mailing Address - Country:US
Mailing Address - Phone:508-558-2112
Mailing Address - Fax:
Practice Address - Street 1:1454 S COUNTY TRL STE 2200
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1749
Practice Address - Country:US
Practice Address - Phone:401-606-2043
Practice Address - Fax:401-606-2041
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN40390163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology