Provider Demographics
NPI:1982949723
Name:O'HAIRE, CHRISTIAN (PHD, CNM, RN)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:
Last Name:O'HAIRE
Suffix:
Gender:
Credentials:PHD, CNM, RN
Other - Prefix:
Other - First Name:CHRISTEN
Other - Middle Name:
Other - Last Name:OHAIRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM, RN, PHD
Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:PRC AND CREDENTIALING
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:2 DUDLEY ST STE 580
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3244
Practice Address - Country:US
Practice Address - Phone:401-274-1122
Practice Address - Fax:401-453-7684
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICNM00196367A00000X
OR201502091NP-PP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500690628Medicaid