Provider Demographics
NPI:1447467071
Name:CARLEY, REBECCA JOY (RNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JOY
Last Name:CARLEY
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 READ SCHOOL HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-8710
Mailing Address - Country:US
Mailing Address - Phone:401-397-6050
Mailing Address - Fax:
Practice Address - Street 1:655 BROAD ST
Practice Address - Street 2:RI FREE CLINIC
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905
Practice Address - Country:US
Practice Address - Phone:401-237-6347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI21227363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health