Provider Demographics
NPI:1821434721
Name:RIOS, JOANA ROSALIE (LPN)
Entity Type:Individual
Prefix:MS
First Name:JOANA
Middle Name:ROSALIE
Last Name:RIOS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 WETHERSFIELD AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06114-3149
Mailing Address - Country:US
Mailing Address - Phone:860-670-9721
Mailing Address - Fax:
Practice Address - Street 1:1010 WETHERSFIELD AVE STE 301
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06114-3149
Practice Address - Country:US
Practice Address - Phone:860-670-9721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT37167164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse