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General NPI Number Information
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NPI Number | 1568421006
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Entity Type | Individual
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Provider Name | JUDY A MISIASZEK APRN
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Gender | Female
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 11/08/2011
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Provider Practice Location Address
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Address Line | 80 ROUTE 125
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City | KINGSTON
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State | NH
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Zip | 03848-3535
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Country | US
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Telephone | 603-642-6700
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Fax | 603-642-6701
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Provider Business Mailing Address
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Address Line | 80 ROUTE 125
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City | KINGSTON
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State | NH
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Zip | 03848-3535
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Country | US
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Telephone | 603-642-6700
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Fax | 603-642-6701
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 027211-23-05
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 92779
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License Number State | MA
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