Individual
MR. DANIEL WILSON FORTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4000
Mailing address
25 BORDEN ST, RIVERSIDE, RI 02915-5672
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN46711
RI
367500000X
Certified Registered Nurse Anesthetist
Primary
RN2322992
MA
Other
Enumeration date
07/16/2021
Last updated
01/30/2023
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