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NPI Code Detail

MEDICARE: VENETTA JOI LAW CNP

MEDICARE: VENETTA JOI LAW CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner401222NY
2363LA2200XAdult Health Nurse PractitionerR121298MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912183393
Entity Type Code : Individual
Provider Name (Legal Business Name) : VENETTA JOI LAW CNP
Provider Business Mailing Address
First Line : PO BOX 130
Second Line : ATTN ACL PROVIDER ENROLLMENT
City : SAN FIDEL
State : NM
Zip : 87049-0130
Country : US
Telephone Number : 505-552-5300
Fax Number : 505-552-5828
Provider Business Practice Location Address
First Line : 6551 NE 150TH AVE
Second Line :
City : WILLISTON
State : FL
Zip : 32696-5321
Country : US
Telephone Number : 443-508-1904
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2008
Last Update Date : 03/24/2021

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