Provider Demographics
NPI:1629643051
Name:WOJNO, KENNETH (RN)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:WOJNO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-5215
Mailing Address - Country:US
Mailing Address - Phone:814-943-0414
Mailing Address - Fax:
Practice Address - Street 1:500 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-5215
Practice Address - Country:US
Practice Address - Phone:814-943-0414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN328594L163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health