Provider Demographics
NPI:1558619536
Name:LEVANDUSKI, LAUREN ANN (NP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ANN
Last Name:LEVANDUSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ANN
Other - Last Name:CHIPPONERI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAUREN ANN CHIPPONER
Mailing Address - Street 1:PO BOX 229
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02880-0229
Mailing Address - Country:US
Mailing Address - Phone:401-788-8757
Mailing Address - Fax:401-782-9867
Practice Address - Street 1:268 POST RD STE 203
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-6601
Practice Address - Country:US
Practice Address - Phone:401-604-2530
Practice Address - Fax:401-604-2560
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN04747363LF0000X
FLARNP9383489363LF0000X
MI4704316428363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1558619536Medicaid
TN6000643OtherBLUE CROSS-BLUE SHIELD
TN1532143Medicaid
TNP01309140OtherRR MEDICARE
TN10350I1886Medicare PIN