Provider Demographics
NPI:1376725432
Name:MUGASIA, JOAN KAHENDI (RN)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:KAHENDI
Last Name:MUGASIA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11115 APACHE DR APT 203
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-9060
Mailing Address - Country:US
Mailing Address - Phone:216-338-5290
Mailing Address - Fax:
Practice Address - Street 1:11115 APACHE DR APT 203
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-9060
Practice Address - Country:US
Practice Address - Phone:216-338-5290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN328755163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse