MEDICARE: MS. JOYCE ANN RASZEWSKI ADVANCED PRACTITCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN 322	HI
2	363LF0000X	Family Nurse Practitioner	R059806	MD
3	363LF0000X	Family Nurse Practitioner	APRN9259620	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DV591Z	OTHER	HI	MEDICARE PART B PTAN #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30522	OTHER	HI	PRESCRIBERS CALL ID
3	RN42683	OTHER	HI	REGISTER NURSE
4	APRN 322	OTHER	HI	HAWAII LICENSURE
5	N59473	OTHER	MD	PRESCRIBER
6	0351175-22	OTHER		AMERICAN NURSES CREDENTIALING CENTER
7	0351175-22	OTHER	MD	ANCC CERTIFICATION
8	APRN9259620	OTHER	FL	LICENSING AND AUDIT SERVICES UNIT
9	R059806	OTHER	MD	LICENSE
10	RN00266	OTHER	HI	CDS

General Provider Information

NPI Number	:	1609812163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOYCE ANN RASZEWSKI ADVANCED PRACTITCE

Provider Business Mailing Address
First Line	:	91-030 MUUMUU PL
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-2414
Country	:	US
Telephone Number	:	443-370-5343
Fax Number	:	808-691-9496

Provider Business Practice Location Address
First Line	:	755 SCOTT CIRCLE
Second Line	:
City	:	JBPHH/HICKAM
State	:	HI
Zip	:	96853
Country	:	US
Telephone Number	:	315-448-6121
Fax Number	:	315-448-6133

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	03/07/2023

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