Provider Demographics
NPI:1124764410
Name:CABRAL, PAMELA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:CABRAL
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3224
Mailing Address - Country:US
Mailing Address - Phone:401-667-6565
Mailing Address - Fax:
Practice Address - Street 1:1443 HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3224
Practice Address - Country:US
Practice Address - Phone:401-667-6565
Practice Address - Fax:401-553-1072
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN71814163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult