Healthcare Provider Details

I. General information

NPI: 1972410256
Provider Name (Legal Business Name): MIKAYLA AUBRIE CONRAD MSN, FNP-C, APRN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MIKAYLA AUBRIE ALBANESE

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 VETERANS MEMORIAL PKWY STE 15B
EAST PROVIDENCE RI
02914-5300
US

IV. Provider business mailing address

20 HARRIS AVE
JOHNSTON RI
02919-2016
US

V. Phone/Fax

Practice location:
  • Phone: 401-434-3350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN05448
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: