Individual
MS. ERICKA DEADWYLER-GOURGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
571 E 19TH ST APT 6B, BROOKLYN, NY 11226-7674
(929) 378-0430
Mailing address
571 E 19TH ST APT 6B, BROOKLYN, NY 11226-7674
(929) 378-0430
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308867
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F405232
NY
Other
Enumeration date
08/15/2018
Last updated
03/12/2025
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