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NPI Code Detail

MEDICARE: OLGA GOREA PMHNP-BC

MEDICARE: OLGA GOREA PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN04213RI
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN100001987MA

General Provider Information

NPI Number : 1417789553
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLGA GOREA PMHNP-BC
Provider Business Mailing Address
First Line : 1130 TEN ROD RD
Second Line :
City : NORTH KINGSTOWN
State : RI
Zip : 02852-4161
Country : US
Telephone Number : 401-446-2350
Fax Number : 855-337-8090
Provider Business Practice Location Address
First Line : 1130 TEN ROD RD STE E305
Second Line :
City : NORTH KINGSTOWN
State : RI
Zip : 02852-4176
Country : US
Telephone Number : 401-294-0451
Fax Number : 855-337-8090
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2024
Last Update Date : 02/03/2026

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Directions to “ OLGA GOREA PMHNP-BC” Practice Location

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