Provider Demographics
NPI:1386773521
Name:RASPALLO, LOUISE D (CRNA)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:D
Last Name:RASPALLO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LOUISE LUTHER DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-6013
Mailing Address - Country:US
Mailing Address - Phone:401-334-1182
Mailing Address - Fax:
Practice Address - Street 1:1725 MENDON RD
Practice Address - Street 2:SUITE 203
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-4337
Practice Address - Country:US
Practice Address - Phone:401-333-6100
Practice Address - Fax:401-333-6109
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICRNA021603367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant