Provider Demographics
NPI:1902411002
Name:MUHANUKA, EVA FIONA (NP)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:FIONA
Last Name:MUHANUKA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 FILLMORE DR
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-2103
Mailing Address - Country:US
Mailing Address - Phone:617-785-5859
Mailing Address - Fax:
Practice Address - Street 1:21 FILLMORE DR
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-2103
Practice Address - Country:US
Practice Address - Phone:617-785-5859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAG08200039363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner