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General NPI Number Information
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NPI Number | 1982909792
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Entity Type | Individual
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Provider Name | CONNIE JO JOZWIAK SHIELDS PH.D., ANP
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Gender | Female
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 8201 MAIN ST STE 1
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-6046
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Country | US
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Telephone | 716-626-6320
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Fax | 716-626-6324
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Provider Business Mailing Address
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Address Line | 8201 MAIN STREET - SUITE 1
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-0000
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Country | US
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Telephone | 716-626-6320
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Fax | 716-626-6324
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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 | 3024851
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License Number State | NY
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