Provider Demographics
NPI:1720005184
Name:AVERY, ANN Z (MSN)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:Z
Last Name:AVERY
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:311 DORIC AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-2903
Mailing Address - Country:US
Mailing Address - Phone:401-467-9610
Mailing Address - Fax:401-467-9030
Practice Address - Street 1:191 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816-7244
Practice Address - Country:US
Practice Address - Phone:401-828-5335
Practice Address - Fax:401-828-2914
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICNPP27096207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine