Healthcare Provider Details

I. General information

NPI: 1144012287
Provider Name (Legal Business Name): JESSICA ANELUNDI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

588 PAWTUCKET AVE
PAWTUCKET RI
02860-6057
US

IV. Provider business mailing address

393 CONGRESS ST
WOONSOCKET RI
02895-4892
US

V. Phone/Fax

Practice location:
  • Phone: 401-728-6500
  • Fax: 401-728-6509
Mailing address:
  • Phone: 508-409-7160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN04577
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License NumberAPRN04577
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: