Healthcare Provider Details

I. General information

NPI: 1982219622
Provider Name (Legal Business Name): RAMONA NUNEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73D WINTHROP AVE
LAWRENCE MA
01843-3716
US

IV. Provider business mailing address

600 BULFINCH DR APT 407
ANDOVER MA
01810-1130
US

V. Phone/Fax

Practice location:
  • Phone: 978-686-3017
  • Fax:
Mailing address:
  • Phone: 978-853-5956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number217990
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: