Provider Demographics
NPI:1245000660
Name:NAZZIWA, JOANITER
Entity type:Individual
Prefix:
First Name:JOANITER
Middle Name:
Last Name:NAZZIWA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3280
Mailing Address - Country:US
Mailing Address - Phone:781-513-0577
Mailing Address - Fax:
Practice Address - Street 1:11 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3280
Practice Address - Country:US
Practice Address - Phone:781-513-0577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN102419164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse