Healthcare Provider Details

I. General information

NPI: 1265985840
Provider Name (Legal Business Name): WHITNEY OGBO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2016
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 EDDIE DOWLING HWY STE 8
NORTH SMITHFIELD RI
02896-7322
US

IV. Provider business mailing address

1150 RESERVOIR AVE STE 305-A
CRANSTON RI
02920-6068
US

V. Phone/Fax

Practice location:
  • Phone: 781-666-2711
  • Fax:
Mailing address:
  • Phone: 401-259-0340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN01431
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberMCS005344B
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: