Provider Demographics
NPI:1952128779
Name:NWETBEFUA, JULIUS NKEZEA
Entity type:Individual
Prefix:
First Name:JULIUS
Middle Name:NKEZEA
Last Name:NWETBEFUA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 MOORELAND AVE
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-2430
Mailing Address - Country:US
Mailing Address - Phone:781-346-2742
Mailing Address - Fax:
Practice Address - Street 1:82 MOORELAND AVE
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2430
Practice Address - Country:US
Practice Address - Phone:781-346-2742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN10002503163WM0705X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical