Provider Demographics
NPI:1386736239
Name:MISENCIK, JOAN MARIE (RN)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:MARIE
Last Name:MISENCIK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10802 TOPBRANCH LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3692
Mailing Address - Country:US
Mailing Address - Phone:410-740-1315
Mailing Address - Fax:
Practice Address - Street 1:VA MEDICAL CTR
Practice Address - Street 2:50 IRVING ST N.W.
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-745-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTE41975163WC3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation