Healthcare Provider Details

I. General information

NPI: 1558250175
Provider Name (Legal Business Name): MELANIE ROSE BAESZLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELANIE ROSE ADAMS

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

15 LA SALLE SQ
PROVIDENCE RI
02903-1814
US

V. Phone/Fax

Practice location:
  • Phone: 401-793-5700
  • Fax: 401-793-7801
Mailing address:
  • Phone: 401-439-3192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN04801
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: