Provider Demographics
NPI:1447845037
Name:SPARROW, RAEJEAN ELIZABETH (APRN)
Entity type:Individual
Prefix:MRS
First Name:RAEJEAN
Middle Name:ELIZABETH
Last Name:SPARROW
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:RAEJEAN
Other - Middle Name:ELIZABETH
Other - Last Name:PEARSE-THEROUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:96 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-3321
Mailing Address - Country:US
Mailing Address - Phone:603-831-1477
Mailing Address - Fax:
Practice Address - Street 1:360 KINGSTOWN RD UNIT 202
Practice Address - Street 2:
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-3258
Practice Address - Country:US
Practice Address - Phone:401-789-1860
Practice Address - Fax:401-782-6850
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02322363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily