Provider Demographics
NPI:1376828913
Name:ANKNER, GINA (NP)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:ANKNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 W RIVER ST
Mailing Address - Street 2:SECOND FLOOR, SUITE 11C
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-2609
Mailing Address - Country:US
Mailing Address - Phone:401-793-7816
Mailing Address - Fax:401-793-7408
Practice Address - Street 1:146 W RIVER ST
Practice Address - Street 2:SECOND FLOOR, SUITE 11C
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-2609
Practice Address - Country:US
Practice Address - Phone:401-793-7816
Practice Address - Fax:401-793-7408
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP31916363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health