Provider Demographics
NPI:1932879475
Name:LUWEDDE, JOANITTA (LPN)
Entity type:Individual
Prefix:
First Name:JOANITTA
Middle Name:
Last Name:LUWEDDE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 BRIARWOOD LN APT 9
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-2519
Mailing Address - Country:US
Mailing Address - Phone:774-244-9040
Mailing Address - Fax:
Practice Address - Street 1:41 BRIARWOOD LN APT 9
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-2519
Practice Address - Country:US
Practice Address - Phone:774-244-9040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN99140164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse