Healthcare Provider Details

I. General information

NPI: 1396680450
Provider Name (Legal Business Name): ELIZABETH ASHTON FRASER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 TOLL GATE RD
WARWICK RI
02886-2770
US

IV. Provider business mailing address

12 DARTMOUTH AVE
WARWICK RI
02888-4416
US

V. Phone/Fax

Practice location:
  • Phone: 401-595-5698
  • Fax:
Mailing address:
  • Phone: 401-595-5698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN66338
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: