Healthcare Provider Details

I. General information

NPI: 1528978921
Provider Name (Legal Business Name): CHEYANNE DOS SANTOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 ELMWOOD AVE
PROVIDENCE RI
02907-1701
US

IV. Provider business mailing address

520 ELMWOOD AVE
PROVIDENCE RI
02907-1701
US

V. Phone/Fax

Practice location:
  • Phone: 401-386-4343
  • Fax: 401-386-4355
Mailing address:
  • Phone: 401-386-4343
  • Fax: 401-386-4355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN05414
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: