Provider Demographics
NPI:1376535179
Name:DUGGAN, ANN L (CRNA)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:L
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 RESERVOIR AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-4450
Mailing Address - Country:US
Mailing Address - Phone:401-944-3800
Mailing Address - Fax:401-943-3129
Practice Address - Street 1:725 RESERVOIR AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-4450
Practice Address - Country:US
Practice Address - Phone:401-944-3800
Practice Address - Fax:401-943-3129
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA086053367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI410297OtherBLUE CHIP
RI321134OtherBLUE CROSS