Provider Demographics
NPI:1306902044
Name:ANDRADE, ANNE MARIE (RNC, ANP)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:RNC, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-1440
Mailing Address - Country:US
Mailing Address - Phone:401-253-1252
Mailing Address - Fax:
Practice Address - Street 1:1 OLD FERRY RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-2923
Practice Address - Country:US
Practice Address - Phone:401-254-3156
Practice Address - Fax:401-254-3305
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP21199363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICNPP21199OtherSTATE LICENSE
RIMA1212391OtherDEA