Provider Demographics
NPI:1447260682
Name:STONE, MARY A (RN, CDE)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:A
Last Name:STONE
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BLACKSTONE
Mailing Address - State:MA
Mailing Address - Zip Code:01504-1108
Mailing Address - Country:US
Mailing Address - Phone:508-883-7541
Mailing Address - Fax:
Practice Address - Street 1:186 CASS AVE
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4712
Practice Address - Country:US
Practice Address - Phone:401-769-9355
Practice Address - Fax:401-765-1721
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN30599163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI63-00064OtherUNITED HEALTHCARE
RI405803OtherBLUE CHIP
RI31281-5OtherBLUE CROSS