1447845037 NPI number — MRS. RAEJEAN ELIZABETH SPARROW APRN

Table of content: MRS. RAEJEAN ELIZABETH SPARROW APRN (NPI 1447845037)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447845037 NPI number — MRS. RAEJEAN ELIZABETH SPARROW APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPARROW
Provider First Name:
RAEJEAN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PEARSE-THEROUX
Provider Other First Name:
RAEJEAN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447845037
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 202230
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75320-2230
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-943-1300
Provider Business Mailing Address Fax Number:
401-946-8480

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1150 RESERVOIR AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CRANSTON
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02920-6068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-943-1300
Provider Business Practice Location Address Fax Number:
401-946-8480
Provider Enumeration Date:
03/04/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  APRN02322 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: APRN02322 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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