Individual provider · Type 1 NPI
Ericka Deadwyler-Gourgue, NURSE PRACTITIONER
Adult Health Nurse Practitioner · Brooklyn, NY
NPI number
1689154130
Active
Practice location
571 E 19th St Apt 6B
Brooklyn, NY 11226-7674
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | F405232 (NY) |
| Adult Health Nurse Practitioner Primary | 363LA2200X | 308867 (NY) |
Adult Health Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1689154130
Ericka Deadwyler-Gourgue, NURSE PRACTITIONER's National Provider Identifier is 1689154130, issued on Aug 15, 2018. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Brooklyn, NY. The record was last updated on Mar 12, 2025.