Provider Demographics
NPI:1922703123
Name:CANNING, DEBORAH J (RN,CDOE)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:CANNING
Suffix:
Gender:F
Credentials:RN,CDOE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 DUDLEY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-2499
Mailing Address - Country:US
Mailing Address - Phone:401-274-1100
Mailing Address - Fax:401-453-7748
Practice Address - Street 1:100 DUDLEY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3233
Practice Address - Country:US
Practice Address - Phone:401-453-7950
Practice Address - Fax:402-453-7748
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN30996163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator