Provider Demographics
NPI:1427470996
Name:PHEASANT, JOANNA ALISE (ARNP)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:ALISE
Last Name:PHEASANT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:ALISE
Other - Last Name:RINALDI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:30 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2052
Mailing Address - Country:US
Mailing Address - Phone:413-582-2898
Mailing Address - Fax:413-582-2958
Practice Address - Street 1:14 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:MA
Practice Address - Zip Code:01096-9427
Practice Address - Country:US
Practice Address - Phone:413-268-3616
Practice Address - Fax:413-923-9311
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2290734363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health