Provider Demographics
NPI:1225097140
Name:NADEAU, CLAIRE AMANDA (FNP)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:AMANDA
Last Name:NADEAU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 ATWOOD AVE
Mailing Address - Street 2:SUITE 434
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3228
Mailing Address - Country:US
Mailing Address - Phone:401-272-8773
Mailing Address - Fax:401-272-8770
Practice Address - Street 1:1524 ATWOOD AVE
Practice Address - Street 2:SUITE 434
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-272-8773
Practice Address - Fax:401-272-8770
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN24184363LF0000X
CT002318363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIS54183Medicare UPIN