Provider Demographics
NPI:1699107565
Name:BOTELHO, CHRISTINA PAULA (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:PAULA
Last Name:BOTELHO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:PAULA
Other - Last Name:DACOSTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:6 BLACKSTONE VALLEY PL
Practice Address - Street 2:SUITE 701
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1179
Practice Address - Country:US
Practice Address - Phone:401-333-3111
Practice Address - Fax:401-334-1217
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2020-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN00593363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily