Provider Demographics
NPI:1871116996
Name:CORDEIRO, MARISSA ELIZABETH SIMEONE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:ELIZABETH SIMEONE
Last Name:CORDEIRO
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:ELIZABETH
Other - Last Name:SIMEONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:151 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-5023
Mailing Address - Country:US
Mailing Address - Phone:401-374-3184
Mailing Address - Fax:
Practice Address - Street 1:334 COUNTY RD STE D
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-2430
Practice Address - Country:US
Practice Address - Phone:401-247-2288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN52453163W00000X
RIAPRN02287363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse