Healthcare Provider Details

I. General information

NPI: 1881636520
Provider Name (Legal Business Name): CECILIA M ANSON-WONKKA MSRNCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CECILIA M ANSON MSRNCS

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 12/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 BEECH STREET HOLYOKE MEDICAL CENTER
HOLYOKE MA
01040
US

IV. Provider business mailing address

319 BEECH ST
HOLYOKE MA
01040-3968
US

V. Phone/Fax

Practice location:
  • Phone: 413-534-2500
  • Fax:
Mailing address:
  • Phone: 413-540-1155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number175589
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: