Provider Demographics
NPI:1891336293
Name:OGNI, ERICA KRISTEN (APRN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:KRISTEN
Last Name:OGNI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:NYBLOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:725 RESERVOIR AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-4451
Mailing Address - Country:US
Mailing Address - Phone:401-829-4446
Mailing Address - Fax:401-829-4434
Practice Address - Street 1:725 RESERVOIR AVE STE 103
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-4451
Practice Address - Country:US
Practice Address - Phone:401-829-4446
Practice Address - Fax:401-829-4434
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02170363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health