MEDICARE: ELAINE DESROSIERS HART NP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	RN 16786	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	697704	OTHER	RI	HARVARD PILGRIM HEALTH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0000030891	OTHER	RI	B/S
4	406137	OTHER	RI	TUFTS HEALTH PLANS
5	04-00518	OTHER	RI	UNITED HEALTH CARE
6	405673	OTHER	RI	BCHIP
7	3862	OTHER	RI	NEIGHBORHOOH HEALTH PLANS

General Provider Information

NPI Number	:	1952302697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE DESROSIERS HART NP

Provider Business Mailing Address
First Line	:	1180 HOPE ST
Second Line	:
City	:	BRISTOL
State	:	RI
Zip	:	02809-1126
Country	:	US
Telephone Number	:	401-247-0610
Fax Number	:	401-245-7362

Provider Business Practice Location Address
First Line	:	286 MAPLE AVE
Second Line	:
City	:	BARRINGTON
State	:	RI
Zip	:	02806-3437
Country	:	US
Telephone Number	:	401-247-0610
Fax Number	:	401-245-7362

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	04/17/2008

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