Individual provider · NPI-1

Modupe S Akinfolarin, NP-C

Nurse Practitioner, Gerontology · Providence, RI

NPI number1871899773
StatusActive
Last updated in NPPESJul 9, 2024

Details

NPI
1871899773
Entity type
Individual (NPI-1)
Name
Modupe S Akinfolarin
Credential
NP-C
Sex
Female
Sole proprietor
No
Enumeration date
Feb 10, 2011
Certification date
Jul 9, 2024
Last updated
Jul 9, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LG0600X Nurse Practitioner, GerontologyAPRN01621RIYes
363LP2300X Nurse Practitioner, Primary CareAPRN01621RI

Practice location

345 Blackstone Blvd
Providence, RI 02906-4800

Phone 401-680-6502 · Fax 401-680-4128

Mailing address

455 Tollgate Rd
Professional Revenue Cycle And Credentialing
Warwick, RI 02886-2759

Phone 401-273-0641 · Fax 401-273-2919

Other practice locations

1070 Main St
Pawtucket, RI 02860-4847

Phone 401-721-5901

40 Howard Ave
Cranston, RI 02920-3031

Phone 401-462-1000

910 Douglas Pike
Smithfield, RI 02917-1874

Phone 401-459-6000

910 Douglas Pike
Smithfield, RI 02917-1874

Phone 401-427-6727

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