Provider Demographics
NPI:1144500356
Name:TAVARES, LAURA ELIZABETH (ARNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ELIZABETH
Last Name:TAVARES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:E
Other - Last Name:TAVARES COVELLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:900 WARREN AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-1430
Mailing Address - Country:US
Mailing Address - Phone:401-331-1221
Mailing Address - Fax:401-751-8003
Practice Address - Street 1:900 WARREN AVE STE 400
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1430
Practice Address - Country:US
Practice Address - Phone:401-331-1221
Practice Address - Fax:401-751-8003
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN00444363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care