Provider Demographics
NPI:1609812163
Name:RASZEWSKI, JOYCE ANN (ADVANCED PRACTITCE)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:ANN
Last Name:RASZEWSKI
Suffix:
Gender:F
Credentials:ADVANCED PRACTITCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-030 MUUMUU PL
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-2414
Mailing Address - Country:US
Mailing Address - Phone:443-370-5343
Mailing Address - Fax:808-691-9496
Practice Address - Street 1:755 SCOTT CIRCLE
Practice Address - Street 2:
Practice Address - City:JBPHH/HICKAM
Practice Address - State:HI
Practice Address - Zip Code:96853
Practice Address - Country:US
Practice Address - Phone:315-448-6121
Practice Address - Fax:315-448-6133
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN 322363LF0000X
MDR059806363LF0000X
FLAPRN9259620363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI30522OtherPRESCRIBERS CALL ID
HIDV591ZOtherMEDICARE PART B PTAN #
HIRN42683OtherREGISTER NURSE
HIAPRN 322OtherHAWAII LICENSURE
MDN59473OtherPRESCRIBER
0351175-22OtherAMERICAN NURSES CREDENTIALING CENTER
MD0351175-22OtherANCC CERTIFICATION
FLAPRN9259620OtherLICENSING AND AUDIT SERVICES UNIT
MDR059806OtherLICENSE
HIRN00266OtherCDS
HIRN00266OtherCDS
MDN59473OtherPRESCRIBER
DC019537M72Medicare PIN