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Organization
MINDFUL CARE NP IN PSYCHIATRY AND NP IN ADULT HEALTH PC
Active
Organization
MINDFUL CARE NP IN PSYCHIATRY AND NP IN ADULT HEALTH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICKA DEADWYLER-GOURGUE NP (OWNER)
(929) 274-5188
Entity
Organization
Contact information
Practice address
571 E 19TH ST APT 6B, BROOKLYN, NY 11226-7674
(929) 322-1924
Mailing address
571 E 19TH ST APT 6B, BROOKLYN, NY 11226-7674
(929) 274-5188
(929) 274-5330
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
03/05/2024
Last updated
05/12/2025
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