Healthcare Provider Details

I. General information

NPI: 1083283196
Provider Name (Legal Business Name): GINA D'AGUANNO APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 SCRABBLETOWN RD STE A
NORTH KINGSTOWN RI
02852-3638
US

IV. Provider business mailing address

47 DANIELSON PIKE
NORTH SCITUATE RI
02857-1892
US

V. Phone/Fax

Practice location:
  • Phone: 401-268-5333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN227184
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN03021
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN35031
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: