Provider Demographics
NPI:1306674643
Name:MAWA, JANAT UL (RN, BSN)
Entity type:Individual
Prefix:
First Name:JANAT
Middle Name:UL
Last Name:MAWA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 HUNTERS RUN PL
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-3641
Mailing Address - Country:US
Mailing Address - Phone:978-476-3198
Mailing Address - Fax:
Practice Address - Street 1:1 GRIFFIN BROOK DR
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-1865
Practice Address - Country:US
Practice Address - Phone:978-686-2497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN10004936163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse