Basic Information
Provider Information
NPI: 1265825053
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STROBLE
FirstName: JUSTINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1700
Address2:  
City: WOONSOCKET
State: RI
PostalCode: 028950856
CountryCode: US
TelephoneNumber: 4012357000
FaxNumber:  
Practice Location
Address1: 1950 TOWER HILL RD
Address2:  
City: NORTH KINGSTOWN
State: RI
PostalCode: 028526639
CountryCode: US
TelephoneNumber: 4012946160
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/18/2015
LastUpdateDate: 03/18/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN54241RIY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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