Provider Demographics
NPI:1497559975
Name:JOSEPH, MARIE JOHANNE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:JOHANNE
Last Name:JOSEPH
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 1:28 GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:STURBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01518-1003
Mailing Address - Country:US
Mailing Address - Phone:857-247-0428
Mailing Address - Fax:
Practice Address - Street 1:28 GLENDALE RD
Practice Address - Street 2:
Practice Address - City:STURBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01518-1003
Practice Address - Country:US
Practice Address - Phone:857-247-0428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2294744163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse