Provider Demographics
NPI:1538797527
Name:OKSANISH, NICOLE ANN (FNP-C, RN)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ANN
Last Name:OKSANISH
Suffix:
Gender:F
Credentials:FNP-C, RN
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:ANN
Other - Last Name:CHADBOUME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:595 WASHINGTON STREE
Practice Address - Street 2:CNEMG PRIMARY CARE OF COVENTRY
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816
Practice Address - Country:US
Practice Address - Phone:401-822-2772
Practice Address - Fax:401-821-5260
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2267506163WE0003X, 363LF0000X
RIAPRN04216363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency