Healthcare Provider Details

I. General information

NPI: 1568884948
Provider Name (Legal Business Name): SHERYL A DIBERNARDO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHERYL A NOLTE CRNA

II. Dates (important events)

Enumeration Date: 01/20/2014
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST DAVOL 129
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

1 VIRGINIA AVE SUITE 201
PROVIDENCE RI
02905-4427
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-4933
  • Fax: 401-444-5090
Mailing address:
  • Phone: 401-490-0927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN00478
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: