Provider Demographics
NPI:1922829696
Name:HARTEN, THERESA LYNN (RN, CARN)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:LYNN
Last Name:HARTEN
Suffix:
Gender:F
Credentials:RN, CARN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 SMITHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-2718
Mailing Address - Country:US
Mailing Address - Phone:401-323-7529
Mailing Address - Fax:
Practice Address - Street 1:50 HEALTH LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2711
Practice Address - Country:US
Practice Address - Phone:401-519-5626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN54800163W00000X, 163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163W00000XNursing Service ProvidersRegistered Nurse