Provider Demographics
NPI:1568169423
Name:GAULIN, SHAUNA EILEEN
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:EILEEN
Last Name:GAULIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:EILEEN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 BLACKSTONE VALLEY PL STE 701
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-1170
Mailing Address - Country:US
Mailing Address - Phone:401-333-3111
Mailing Address - Fax:401-334-1217
Practice Address - Street 1:6 BLACKSTONE VALLEY PL STE 701
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1170
Practice Address - Country:US
Practice Address - Phone:401-333-3111
Practice Address - Fax:401-334-1217
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN04005363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner