Healthcare Provider Details

I. General information

NPI: 1144322868
Provider Name (Legal Business Name): ANN S BUCHANAN PCNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HIGH SERVICE AVENUE
NORTH PROVIDENCE RI
02904
US

IV. Provider business mailing address

200 HIGH SERVICE AVENUE MARIAN HALL 1ST FLOOR
NORTH PROVIDENCE RI
02904
US

V. Phone/Fax

Practice location:
  • Phone: 401-456-3300
  • Fax: 401-752-8113
Mailing address:
  • Phone: 401-456-3649
  • Fax: 401-752-8116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberRN21672
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: