MEDICARE: AESTHETIC HAVEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363LF0000X	Family Nurse Practitioner
2	363LP2300X	Primary Care Nurse Practitioner
3	163WG0000X	General Practice Registered Nurse
4	101YM0800X	Mental Health Counselor
5	261QP2300X	Primary Care Clinic/Center
6	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1306655253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AESTHETIC HAVEN

Provider Business Mailing Address
First Line	:	300 INDUSTRIAL WAY
Second Line	:
City	:	TIVERTON
State	:	RI
Zip	:	02878-3133
Country	:	US
Telephone Number	:	401-535-6104
Fax Number	:	401-340-1885

Provider Business Practice Location Address
First Line	:	300 INDUSTRIAL WAY
Second Line	:	FL 3, SUITE 4, ROOM 4
City	:	TIVERTON
State	:	RI
Zip	:	02878-3133
Country	:	US
Telephone Number	:	401-535-6104
Fax Number	:	401-340-1885

Authorized Official
Title or Position	:	OWNER/NP
Name	:	SAMANTHA R TURCOTTE
Credential	:	DNP, MSN, APRN, FNP
Telephone Number	:	401-535-6104

Provider Enumeration Date	:	01/06/2025
Last Update Date	:	06/03/2026

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Directions to “AESTHETIC HAVEN ” Practice Location

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