Provider Demographics
NPI:1053460584
Name:PEATFIELD, JOANNA G (MSRN,BC)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:G
Last Name:PEATFIELD
Suffix:
Gender:F
Credentials:MSRN,BC
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:360 MERRIMACK ST
Mailing Address - Street 2:STE 9
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1764
Mailing Address - Country:US
Mailing Address - Phone:978-655-6652
Mailing Address - Fax:978-655-6653
Practice Address - Street 1:360 MERRIMACK ST
Practice Address - Street 2:STE 9
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1764
Practice Address - Country:US
Practice Address - Phone:978-655-6652
Practice Address - Fax:978-655-6653
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA157069363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA568275Medicare UPIN