Provider Demographics
NPI:1588764716
Name:FIRESTONE, ANNE-MARIE IRENE (RN, CDE, CDOE)
Entity type:Individual
Prefix:
First Name:ANNE-MARIE
Middle Name:IRENE
Last Name:FIRESTONE
Suffix:
Gender:F
Credentials:RN, CDE, CDOE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 W RIVER ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-2615
Mailing Address - Country:US
Mailing Address - Phone:401-861-2233
Mailing Address - Fax:401-861-0376
Practice Address - Street 1:148 W RIVER ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-2615
Practice Address - Country:US
Practice Address - Phone:401-861-2233
Practice Address - Fax:401-861-0376
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN25618163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator