Provider Demographics
NPI:1043455694
Name:DIGATI, GINA MARIA (RN, MS, PCNS-BC)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:MARIA
Last Name:DIGATI
Suffix:
Gender:F
Credentials:RN, MS, PCNS-BC
Other - Prefix:
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Mailing Address - Street 1:115 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-2125
Mailing Address - Country:US
Mailing Address - Phone:401-477-4681
Mailing Address - Fax:401-396-5324
Practice Address - Street 1:3047 E MAIN RD
Practice Address - Street 2:SUITE 4 B
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-4262
Practice Address - Country:US
Practice Address - Phone:401-477-4681
Practice Address - Fax:401-396-5324
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICPPNS00099364SP0809X
MA209687364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1306685Medicaid