Jacquelyn M Arieta, FNP

Individual provider Active NPI Family Nurse Practitioner · Lincoln, RI

NPI 1679560718 · NPPES record last updated Oct 19, 2020

Key facts

NPI
1679560718
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
APRN00817 (RI)
Practice address
1 Commerce St
Anchor Medical Associates Pediatric Department
Lincoln, RI 02865-1168
Phone
(401) 793-8484
Fax
(401) 793-8481
NPI assigned
Oct 4, 2005
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20090424000145 RI Practitioner - Nurse Practitioner 5092718270

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
152166MAMDNurse Practitioner
CAPRN00817RIMDFamily Nurse Practitioner
RN25654RIMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 152166 MA
Family Nurse Practitioner 363LF0000X RN25654 RI
Family Nurse Practitioner 363LF0000X CAPRN00817 RI
Family Nurse Practitioner 363LF0000X APRN00817 RI Yes

Addresses

Primary practice location

1 Commerce St
Anchor Medical Associates Pediatric Department
Lincoln, RI 02865-1168

Mailing address

1 Commerce St
Anchor Medical Associates Pediatric Department
Lincoln, RI 02865-1168
Phone (401) 793-8484

Other identifiers

IdentifierTypeStateIssuer
0799785MedicaidMA
31351-3OtherRIBCBSRI
78089OtherMACHILDRENS MEDICAL SECURIT
0037810OtherMANEIGHBORHOOD HEALTH PLAN
413415OtherRIBCBSRIBLUCHIP
NP2548OtherMABCBSMA

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address jacquelyn.arieta@10.direct.athenahealth.com

Other providers in Lincoln, RI

All providers in Lincoln, RI · Family Nurse Practitioner in Rhode Island

Sources for this page

Verify at the official NPI Registry.