Provider Demographics
NPI:1518980176
Name:LAPRADE, ANNETTE MARIE (RN, CDE, CDOE, CPT)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:MARIE
Last Name:LAPRADE
Suffix:
Gender:F
Credentials:RN, CDE, CDOE, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 PONTIAC AVE
Mailing Address - Street 2:APT. 8302
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-5901
Mailing Address - Country:US
Mailing Address - Phone:401-946-1240
Mailing Address - Fax:
Practice Address - Street 1:830 CHALKSTONE AVE
Practice Address - Street 2:MAIL 11B
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-4734
Practice Address - Country:US
Practice Address - Phone:401-273-7100
Practice Address - Fax:401-525-2549
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI22829163WD0400X
MA150631163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI408605OtherBLUE CHIP PROVIDER
RI63-02180OtherUNITED HEALTHCARE PROVIDE
RI23556-7OtherBLUE CROSS PROVIDER