Provider Demographics
NPI:1437529294
Name:KAYONGO, LOYCE (RN)
Entity Type:Individual
Prefix:
First Name:LOYCE
Middle Name:
Last Name:KAYONGO
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 1:2 WINTER ST STE 104
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-0960
Mailing Address - Country:US
Mailing Address - Phone:781-472-2760
Mailing Address - Fax:781-472-2761
Practice Address - Street 1:691 MAIN ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-0609
Practice Address - Country:US
Practice Address - Phone:781-472-2760
Practice Address - Fax:781-472-2861
Is Sole Proprietor?:No
Enumeration Date:2015-10-05
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2281548163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse