Healthcare Provider Details

I. General information

NPI: 1306655253
Provider Name (Legal Business Name): AESTHETIC HAVEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 INDUSTRIAL WAY FL 3, SUITE 4, ROOM 4
TIVERTON RI
02878-3133
US

IV. Provider business mailing address

300 INDUSTRIAL WAY
TIVERTON RI
02878-3133
US

V. Phone/Fax

Practice location:
  • Phone: 401-535-6104
  • Fax: 401-340-1885
Mailing address:
  • Phone: 401-535-6104
  • Fax: 401-340-1885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA R TURCOTTE
Title or Position: OWNER/NP
Credential: DNP, MSN, APRN, FNP
Phone: 401-535-6104