Basic Information
| Provider Information | |||||||||
| NPI: | 1770822678 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAQUIN | ||||||||
| FirstName: | ALICIA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | RN, MS, WHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 39 EAST AVE | ||||||||
| Address2: | |||||||||
| City: | PAWTUCKET | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028604003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017220081 | ||||||||
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| Practice Location | |||||||||
| Address1: | 39 EAST AVE | ||||||||
| Address2: | |||||||||
| City: | PAWTUCKET | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028604003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017220081 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2013 | ||||||||
| LastUpdateDate: | 03/07/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | RN2261558 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | 363LW0102X | APRN00793 | RI | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.