Provider Demographics
NPI:1720065337
Name:VOLLUCCI, ELIZABETH ANN (RNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:VOLLUCCI
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:124 BATES TRL
Mailing Address - Street 2:
Mailing Address - City:WEST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02817-2554
Mailing Address - Country:US
Mailing Address - Phone:401-397-5101
Mailing Address - Fax:401-385-9260
Practice Address - Street 1:390 TOLL GATE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4326
Practice Address - Country:US
Practice Address - Phone:401-738-8800
Practice Address - Fax:401-738-7670
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP37118363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI4076OtherNEIGHBORHOOD HEALTH PLAN
RI01-01441OtherUNITED HEALTH PLAN
RI408158OtherBLUE CROSS & BLUE CHIP
P29134Medicare UPIN
23237-9Medicare ID - Type Unspecified