| Primary & Psychiatric Integrated Care | |
|
215 Legris Ave West Warwick RI 02893-2937 | |
| (401) 234-6685 | |
| Not Available |
| Full Name | Primary & Psychiatric Integrated Care |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 215 Legris Ave, West Warwick, Rhode Island |
| Authorized Official Name and Position | Hollie Ann Colucci (CEO) |
| Authorized Official Contact | 4012346685 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary & Psychiatric Integrated Care 215 Legris Ave West Warwick RI 02893-2937 Ph: (401) 234-6685 | Primary & Psychiatric Integrated Care 215 Legris Ave West Warwick RI 02893-2937 Ph: (401) 234-6685 |
| NPI Number | 1508483694 |
|---|---|
| Provider Enumeration Date | 07/06/2020 |
| Last Update Date | 12/16/2021 |
| Medicare PECOS PAC ID | 3072930064 |
|---|---|
| Medicare Enrollment ID | O20200908000560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508483694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Hollie Ann Colucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205308913 PECOS PAC ID: 9234477357 Enrollment ID: I20190215001292 |
| Provider Name | Katelyn Rose Agnew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972122364 PECOS PAC ID: 6103247093 Enrollment ID: I20200601002681 |
| Provider Name | Jeannie-mae Durfee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699298802 PECOS PAC ID: 4082988233 Enrollment ID: I20210818000794 |
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