Provider Demographics
NPI:1790235257
Name:FONDI, GRESILLA (RN)
Entity Type:Individual
Prefix:
First Name:GRESILLA
Middle Name:
Last Name:FONDI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GRESILLA
Other - Middle Name:
Other - Last Name:AROKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 OSBORNE HILL DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-1022
Mailing Address - Country:US
Mailing Address - Phone:978-335-2914
Mailing Address - Fax:
Practice Address - Street 1:81 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2714
Practice Address - Country:US
Practice Address - Phone:978-335-2914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-09
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN268082363L00000X
MA648459390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program