Healthcare Provider Details

I. General information

NPI: 1982954160
Provider Name (Legal Business Name): KATHRYN BASQUES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2012
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1052 PARK AVE
CRANSTON RI
02910-3225
US

IV. Provider business mailing address

200 CORLISS ST
PROVIDENCE RI
02904-2602
US

V. Phone/Fax

Practice location:
  • Phone: 401-461-5056
  • Fax:
Mailing address:
  • Phone: 401-606-8530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ01040900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5144
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN02787
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: