Basic Information
| Provider Information | |||||||||
| NPI: | 1144701301 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAPONT | ||||||||
| FirstName: | MIRANDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 TEMPLE DR | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029151124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4019352791 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2 OLD COUNTY RD | ||||||||
| Address2: | |||||||||
| City: | BARRINGTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 02806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4012461195 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2018 | ||||||||
| LastUpdateDate: | 09/04/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN52402 | RI | Y | Nursing Service Providers | Registered Nurse |
No ID Information.