Provider Demographics
NPI:1518596642
Name:PRABUCKA-DAVIS, IWONA (DNP FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:IWONA
Middle Name:
Last Name:PRABUCKA-DAVIS
Suffix:
Gender:F
Credentials:DNP FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 WASHINGTON ST STE 202
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-5709
Mailing Address - Country:US
Mailing Address - Phone:508-796-9211
Mailing Address - Fax:508-286-6106
Practice Address - Street 1:489 WASHINGTON ST STE 202
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-5709
Practice Address - Country:US
Practice Address - Phone:508-796-9211
Practice Address - Fax:508-286-6106
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-01
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2276408363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MARN2276408OtherBOARD OF REGISTRATION IN NURSING