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General NPI Number Information
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NPI Number | 1417484254
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Entity Type | Individual
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Provider Name | SUSANNA DRAIGHAN APRN
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Gender | Female
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 331 BROADWAY STE 302
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City | PROVIDENCE
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State | RI
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Zip | 02909-1101
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Country | US
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Telephone | 401-217-9377
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Fax | 401-200-3166
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Provider Business Mailing Address
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Address Line | 331 BROADWAY STE 302
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City | PROVIDENCE
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State | RI
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Zip | 02909-1101
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Country | US
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Telephone | 401-217-9377
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Fax | 401-200-3166
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2327944
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN01685
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License Number State | RI
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