Healthcare Provider Details

I. General information

NPI: 1164843884
Provider Name (Legal Business Name): JOANNE FRANCES CERNAUSKAS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2013
Last Update Date: 12/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 ELM ST APT 6
WORCESTER MA
01609-2348
US

IV. Provider business mailing address

77 ELM ST APT 6
WORCESTER MA
01609-2348
US

V. Phone/Fax

Practice location:
  • Phone: 508-753-3639
  • Fax:
Mailing address:
  • Phone: 508-753-3639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number196640
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: