Provider Demographics
NPI:1205953569
Name:CASSESE, CHARLENE JABLONSKI (RNP)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:JABLONSKI
Last Name:CASSESE
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BOULDER WAY
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-5101
Mailing Address - Country:US
Mailing Address - Phone:401-884-0269
Mailing Address - Fax:
Practice Address - Street 1:1126 HARTFORD AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-7130
Practice Address - Country:US
Practice Address - Phone:401-351-2750
Practice Address - Fax:401-351-6613
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP37316363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily