IndividualActive
Joanne Custodio, CRNA
NPI 1447716527 · Certified Registered Nurse Anesthetist · Providence, RI
Provider details
- NPI number
- 1447716527
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CRNA
- Sex
- Female
- Sole proprietor
- No
- License
- RN2305195 (MA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
825 Chalkstone Ave
Providence, RI 02908-4728
Phone: (401) 456-2000
Approximate (ZIP-level) locationGet directions
Mailing address
690 Canton St Ste 325
Westwood, MA 02090-2324
Registry dates
- Enumerated
- 2019-02-14
- Last updated
- 2019-02-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.