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MR. BRIAN KENNETH FONTAINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
62 AMARAL ST STE 100, RIVERSIDE, RI 02915-2205
(352) 275-2064
Mailing address
33 SCARBOROUGH RD, PAWTUCKET, RI 02861-4022
(401) 725-7021

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
241092
MA
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN00008
RI

Other

Enumeration date
09/28/2006
Last updated
07/24/2024
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