# ENIAYO EGBERONGBE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1295263515
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | RN2330024 | MA | — |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | 681574 | NY | — |
| 363LF0000X | Family Nurse Practitioner | APRN01722 | RI | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | APRN01722 | RI | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | RN2330024 | MA | — |

## Other

- **Enumeration date:** 05/31/2017
- **Last updated:** 06/29/2021