Healthcare Provider Details

I. General information

NPI: 1699568477
Provider Name (Legal Business Name): ORNELLA NINA NEZERWE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2025
Last Update Date: 05/26/2025
Certification Date: 05/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 STATE ST APT 5
BIDDEFORD ME
04005-5242
US

IV. Provider business mailing address

24 STATE ST APT 5
BIDDEFORD ME
04005-5242
US

V. Phone/Fax

Practice location:
  • Phone: 207-286-6762
  • Fax:
Mailing address:
  • Phone: 207-286-6762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: