Healthcare Provider Details

I. General information

NPI: 1578275111
Provider Name (Legal Business Name): ASHLEE N SACKETT DNP, APRN, ACCNS-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2022
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 SUMMIT AVE
PROVIDENCE RI
02906-2853
US

IV. Provider business mailing address

55 CITY VIEW AVE
EAST PROVIDENCE RI
02914-3322
US

V. Phone/Fax

Practice location:
  • Phone: 401-793-5400
  • Fax:
Mailing address:
  • Phone: 401-808-7782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberAPRN01553
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: