Provider Demographics
NPI:1538548383
Name:JAMES, MATTHEW RICHARD (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:RICHARD
Last Name:JAMES
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3635
Mailing Address - Country:US
Mailing Address - Phone:800-389-2727
Mailing Address - Fax:
Practice Address - Street 1:799 HOPE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3635
Practice Address - Country:US
Practice Address - Phone:401-331-5240
Practice Address - Fax:401-272-9732
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN00688363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily