Individual
MICHELLE J BRODEUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
101 DUDLEY ST, PROVIDENCE, RI 02905
(401) 453-7950
(401) 453-7658
Mailing address
455 TOLL GATE RD, WARWICK, RI 02886-2759
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN00288
RI
367500000X
Certified Registered Nurse Anesthetist
RNA25993
RI
Other
Enumeration date
12/29/2005
Last updated
11/07/2022
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