| Mr Daniel Wilson Fortin, RN | |
|
593 Eddy St, Providence, RI 02903-4923 | |
| (401) 444-4000 | |
| Not Available |
| Full Name | Mr Daniel Wilson Fortin |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 3 Years |
| Location | 593 Eddy St, Providence, Rhode Island |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801469952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WC0200X | Registered Nurse - Critical Care Medicine | RN46711 (Rhode Island) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | RN2322992 (Massachusetts) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Vincent Hospital | Worcester, MA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lawrence Anesthesia Services Llc | 4082770136 | 112 |
| Entity Name | Lawrence Anesthesia Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467699918 PECOS PAC ID: 4082770136 Enrollment ID: O20090225000707 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Daniel Wilson Fortin, RN 25 Borden St, Riverside, RI 02915-5672 Ph: () - | Mr Daniel Wilson Fortin, RN 593 Eddy St, Providence, RI 02903-4923 Ph: (401) 444-4000 |
Brian F Girard, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy Street, Davol 129, Providence, RI 02903 Phone: 401-444-4933 Fax: 401-444-5090 | |
Peter W Wolferseder, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy Street, Davol 129, Providence, RI 02903 Phone: 401-444-4933 Fax: 401-444-5090 | |
Marie A Mills, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 593 Eddy Street, Davol 129, Providence, RI 02903 Phone: 401-444-4933 Fax: 401-444-5090 | |
Beth Vanpraag, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 593 Eddy Street, Davol 129, Providence, RI 02903 Phone: 401-444-4933 Fax: 401-444-5090 | |
Paulette Champion, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 593 Eddy St, Davol 129, Providence, RI 02903 Phone: 401-444-4933 Fax: 401-444-5090 | |
Angela Thomas, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy Street, Davol 129, Providence, RI 02903 Phone: 401-444-4933 Fax: 401-444-5090 | |
Garrick Mark Whitlock, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 825 Chalkstone Ave, Providence, RI 02908 Phone: 401-456-2000 |