1538797527 NPI number — MRS. NICOLE ANN OKSANISH FNP-C, RN

Table of content: MRS. NICOLE ANN OKSANISH FNP-C, RN (NPI 1538797527)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538797527 NPI number — MRS. NICOLE ANN OKSANISH FNP-C, RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OKSANISH
Provider First Name:
NICOLE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP-C, RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHADBOUME
Provider Other First Name:
NICOLE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538797527
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
455 TOLL GATE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARWICK
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02886-2759
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-273-0641
Provider Business Mailing Address Fax Number:
401-273-2919

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
595 WASHINGTON STREE
Provider Second Line Business Practice Location Address:
CNEMG PRIMARY CARE OF COVENTRY
Provider Business Practice Location Address City Name:
COVENTRY
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-822-2772
Provider Business Practice Location Address Fax Number:
401-821-5260
Provider Enumeration Date:
03/27/2020

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: 163WE0003X , with the licence number:  RN2267506 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: RN2267506 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: APRN04216 , 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)