Basic Information
Provider Information
NPI: 1881877355
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEAUVAIS
FirstName: DEBORAH
MiddleName: ANN
NamePrefix: MRS.
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 116 EDDIE DOWLING HWY
Address2:  
City: NORTH SMITHFIELD
State: RI
PostalCode: 028967327
CountryCode: US
TelephoneNumber: 4017692200
FaxNumber: 4017673136
Practice Location
Address1: 116 EDDIE DOWLING HWY
Address2:  
City: NORTH SMITHFIELD
State: RI
PostalCode: 028967327
CountryCode: US
TelephoneNumber: 4017692200
FaxNumber: 4017673136
Other Information
ProviderEnumerationDate: 12/07/2007
LastUpdateDate: 12/07/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XNPP37443RIY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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