Healthcare Provider Details

I. General information

NPI: 1124501218
Provider Name (Legal Business Name): EVELYN CUADRADO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 HIGHLAND AVE
FALL RIVER MA
02720-3703
US

IV. Provider business mailing address

14 WAYLAND ST
EAST PROVIDENCE RI
02914-3812
US

V. Phone/Fax

Practice location:
  • Phone: 508-973-7014
  • Fax:
Mailing address:
  • Phone: 401-261-5293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number52273
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2305207
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: