Basic Information
| Provider Information | |||||||||
| NPI: | 1376535179 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUGGAN | ||||||||
| FirstName: | ANN | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 725 RESERVOIR AVE | ||||||||
| Address2: | |||||||||
| City: | CRANSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029104450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4019443800 | ||||||||
| FaxNumber: | 4019433129 | ||||||||
| Practice Location | |||||||||
| Address1: | 725 RESERVOIR AVE | ||||||||
| Address2: | |||||||||
| City: | CRANSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029104450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4019443800 | ||||||||
| FaxNumber: | 4019433129 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2005 | ||||||||
| LastUpdateDate: | 12/12/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 086053 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 410297 | 01 | RI | BLUE CHIP | OTHER | 321134 | 01 | RI | BLUE CROSS | OTHER |