Provider Demographics
NPI:1306084025
Name:WESTCOTT, SALLY (RN)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:WESTCOTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705A OLD POST RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02813-1819
Mailing Address - Country:US
Mailing Address - Phone:401-364-7705
Mailing Address - Fax:401-364-9104
Practice Address - Street 1:55 CHERRY LN
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-3617
Practice Address - Country:US
Practice Address - Phone:401-364-1739
Practice Address - Fax:401-364-9104
Is Sole Proprietor?:No
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN47034163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse