Provider Demographics
NPI:1043081391
Name:AMISIAL, JOIENAH ARLISE (APRN)
Entity Type:Individual
Prefix:
First Name:JOIENAH
Middle Name:ARLISE
Last Name:AMISIAL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JOIENAH
Other - Middle Name:ARLISE
Other - Last Name:CAZEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8755 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7178
Mailing Address - Country:US
Mailing Address - Phone:781-910-1568
Mailing Address - Fax:
Practice Address - Street 1:8755 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7178
Practice Address - Country:US
Practice Address - Phone:781-910-1568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028813363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily