Basic Information
Provider Information
NPI: 1932352846
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIOUX
FirstName: WINIFRED
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: RN, MSN, PNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 20 TURNING MILL LN
Address2: #3
City: QUINCY
State: MA
PostalCode: 021691019
CountryCode: US
TelephoneNumber: 6174728191
FaxNumber:  
Practice Location
Address1: 253 SUMMER ST
Address2: 5TH FLR - CMA
City: BOSTON
State: MA
PostalCode: 022101114
CountryCode: US
TelephoneNumber: 8888978947
FaxNumber: 6177725519
Other Information
ProviderEnumerationDate: 10/23/2008
LastUpdateDate: 10/23/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LC1500X176936MAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health

No ID Information.


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