Individual
JOHN R. DUFRESNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
1150 RESERVOIR AVE, SUITE 100, CRANSTON, RI 02920-6068
(401) 946-2400
(401) 946-0107
Mailing address
1150 RESERVOIR AVE, SUITE 100, CRANSTON, RI 02920-6068
(401) 946-2400
(401) 946-0107
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NPP37176
RI
363LF0000X
Family Nurse Practitioner
Primary
NPP37176
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24007-5
BLUECROSS BLUESHIELD
RI
01
—
409038
BLUE CHIP
RI
05
—
7057318
—
RI
01
—
P00217750
RAILROAD
—
Enumeration date
02/22/2006
Last updated
11/29/2018
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