Provider Demographics
NPI:1053671271
Name:NYA, JOSETTE
Entity Type:Individual
Prefix:
First Name:JOSETTE
Middle Name:
Last Name:NYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5915 CHERRYWOOD LN
Mailing Address - Street 2:#103
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-1276
Mailing Address - Country:US
Mailing Address - Phone:240-481-7632
Mailing Address - Fax:
Practice Address - Street 1:5915 CHERRYWOOD LN
Practice Address - Street 2:#103
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1276
Practice Address - Country:US
Practice Address - Phone:240-481-7632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide