| Lisa M Rodrigues, FNP-BC | |
|
110 Elmwood Ave, Providence, RI 02907-2423 | |
| (401) 300-5757 | |
| (401) 300-5656 |
| Full Name | Lisa M Rodrigues |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 110 Elmwood Ave, Providence, Rhode Island |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639454572 | NPI | - | NPPES |
| 110101456A | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | RN214014 (Massachusetts) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | APRN02224 (Rhode Island) | Primary |
| Entity Name | Victa Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104317007 PECOS PAC ID: 0840620894 Enrollment ID: O20200415002461 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa M Rodrigues, FNP-BC 110 Elmwood Ave, Providence, RI 02907-2423 Ph: (401) 300-5757 | Lisa M Rodrigues, FNP-BC 110 Elmwood Ave, Providence, RI 02907-2423 Ph: (401) 300-5757 |
Mrs. Halina Kuc-mazgaj, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 164 Summit Ave, The Miriam Hospital, Providence, RI 02906 Phone: 401-793-3902 | |
Nnemeka A Okpala, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 10 Dorrance St Ste 700, Providence, RI 02903 Phone: 617-419-0482 | |
Phina A Mayu, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1 Randall Sq, Providence, RI 02904 Phone: 401-274-6339 Fax: 401-453-6290 | |
Beverly Casinelli, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 765 Allens Ave, Providence, RI 02905 Phone: 401-606-4150 | |
Kristen Ann Chapian, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 195 Collyer St Ste 302, Providence, RI 02904 Phone: 401-793-5708 Fax: 401-793-5171 | |
Elizabeth Moore Medbury, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 830 Chalkstone Ave, Providence, RI 02908 Phone: 401-273-7011 | |
Abigail Leah Soscia, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 101 Dudley Street, Wih Neonatology/pediatrics, Providence, RI 02905 Phone: 401-274-1122 Fax: 401-453-7571 |