Healthcare Provider Details

I. General information

NPI: 1649704271
Provider Name (Legal Business Name): ASHLEY ERIN DESJARDINS MSN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 11/20/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST
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: 401-444-3500
  • Fax:
Mailing address:
  • Phone: 401-606-1611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN01574
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: