Provider Demographics
NPI:1104405828
Name:NYZIO, JOSEPH (RN)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:NYZIO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 MARSEILLE CT
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-3035
Mailing Address - Country:US
Mailing Address - Phone:760-258-7155
Mailing Address - Fax:
Practice Address - Street 1:1222 MARSEILLE CT
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-3035
Practice Address - Country:US
Practice Address - Phone:760-258-7155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704310125163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse