Healthcare Provider Details

I. General information

NPI: 1427470996
Provider Name (Legal Business Name): JOANNA ALISE PHEASANT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOANNA ALISE RINALDI

II. Dates (important events)

Enumeration Date: 01/17/2014
Last Update Date: 01/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 WILLIAMS ST
WILLIAMSBURG MA
01096-9427
US

IV. Provider business mailing address

30 LOCUST ST
NORTHAMPTON MA
01060-2052
US

V. Phone/Fax

Practice location:
  • Phone: 413-268-3616
  • Fax: 413-923-9311
Mailing address:
  • Phone: 413-582-2898
  • Fax: 413-582-2958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN2290734
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: