Provider Demographics
NPI:1114305497
Name:DAY, JOHN FREDERICK (RN)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FREDERICK
Last Name:DAY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 SCHOOL ST
Mailing Address - Street 2:APT 1
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-2485
Mailing Address - Country:US
Mailing Address - Phone:413-824-1730
Mailing Address - Fax:
Practice Address - Street 1:106 SCHOOL ST
Practice Address - Street 2:APT 1
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2485
Practice Address - Country:US
Practice Address - Phone:413-824-1730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2286593163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA$$$$$$$$$OtherSSN