Provider Demographics
NPI:1649572645
Name:FOURNIER, SANDRA L (RN BSN)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:L
Last Name:FOURNIER
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 FABIEN ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-6277
Mailing Address - Country:US
Mailing Address - Phone:401-765-3700
Mailing Address - Fax:401-769-0646
Practice Address - Street 1:80 FABIEN ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-6277
Practice Address - Country:US
Practice Address - Phone:401-765-3700
Practice Address - Fax:401-769-0646
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2010-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN223566163W00000X
RIRN34293163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163W00000XNursing Service ProvidersRegistered Nurse