Healthcare Provider Details

I. General information

NPI: 1487597209
Provider Name (Legal Business Name): CHARLOTTE ANN GARRETT NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WARREN AVE STE 201
EAST PROVIDENCE RI
02914-1430
US

IV. Provider business mailing address

15 LA SALLE SQ
PROVIDENCE RI
02903-1814
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-8306
  • Fax: 401-793-8670
Mailing address:
  • Phone: 401-444-6779
  • Fax: 401-444-6912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN05174
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: