IndividualActive
Tara Shouldis
NPI 1386435139 · Pediatric Nurse Practitioner · Providence, RI
Provider details
- NPI number
- 1386435139
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 80652 (RI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Nursing Service Providers
Practice location
593 Eddy St
Providence, RI 02903-4923
Phone: (401) 444-4000
Approximate (ZIP-level) locationGet directions
Mailing address
110 Elm St
Providence, RI 02903-4626
Registry dates
- Enumerated
- 2025-05-13
- Last updated
- 2025-08-12
- Certified
- 2025-07-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.