Provider Demographics
NPI:1366693681
Name:MACHARIA, AGNES W (BSN, RN)
Entity Type:Individual
Prefix:
First Name:AGNES
Middle Name:W
Last Name:MACHARIA
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 NASHUA RD
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-1943
Mailing Address - Country:US
Mailing Address - Phone:978-758-5705
Mailing Address - Fax:413-304-6041
Practice Address - Street 1:626 NASHUA RD
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-1943
Practice Address - Country:US
Practice Address - Phone:978-758-5705
Practice Address - Fax:413-304-6041
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA257397163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health