Healthcare Provider Details

I. General information

NPI: 1225097140
Provider Name (Legal Business Name): CLAIRE AMANDA NADEAU FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 09/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 ATWOOD AVE SUITE 434
JOHNSTON RI
02919-3228
US

IV. Provider business mailing address

1524 ATWOOD AVE SUITE 434
JOHNSTON RI
02919-3228
US

V. Phone/Fax

Practice location:
  • Phone: 401-272-8773
  • Fax: 401-272-8770
Mailing address:
  • Phone: 401-272-8773
  • Fax: 401-272-8770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN24184
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number002318
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: