Provider Demographics
NPI:1497421127
Name:BEREZOWSKA, MALGORZATA HELENA (RN)
Entity Type:Individual
Prefix:
First Name:MALGORZATA
Middle Name:HELENA
Last Name:BEREZOWSKA
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 1:6 DELL CT
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-2316
Mailing Address - Country:US
Mailing Address - Phone:859-640-6973
Mailing Address - Fax:
Practice Address - Street 1:6 DELL CT
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2316
Practice Address - Country:US
Practice Address - Phone:859-640-6973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-22
Last Update Date:2021-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1165921163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse