Provider Demographics
NPI:1982001459
Name:NUNEZ, JOHANNA (BSN, RN)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 RHINELANDER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1310
Mailing Address - Country:US
Mailing Address - Phone:914-409-3058
Mailing Address - Fax:
Practice Address - Street 1:1106 RHINELANDER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1310
Practice Address - Country:US
Practice Address - Phone:914-409-3058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-29
Last Update Date:2014-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY680974163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse