Provider Demographics
NPI:1679243430
Name:GATHONI, VERONICAH (RN)
Entity Type:Individual
Prefix:
First Name:VERONICAH
Middle Name:
Last Name:GATHONI
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 1:83 VIOLA ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-4922
Mailing Address - Country:US
Mailing Address - Phone:978-967-9626
Mailing Address - Fax:
Practice Address - Street 1:83 VIOLA ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-4922
Practice Address - Country:US
Practice Address - Phone:978-967-9626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2334453163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MARN2334453OtherRN LICENSE