Provider Demographics
NPI:1144322868
Name:BUCHANAN, ANN S (PCNS)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:S
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:PCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HIGH SERVICE AVENUE
Mailing Address - Street 2:MARIAN HALL 1ST FLOOR
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904
Mailing Address - Country:US
Mailing Address - Phone:401-456-3649
Mailing Address - Fax:401-752-8116
Practice Address - Street 1:200 HIGH SERVICE AVENUE
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904
Practice Address - Country:US
Practice Address - Phone:401-456-3300
Practice Address - Fax:401-752-8113
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN21672364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI6238667OtherUNITED BEHAVIORAL HEALTH
RI25106OtherBLUE CROSS BLUE SHIELD
RI6238667OtherUNITED BEHAVIORAL HEALTH