Provider Demographics
NPI:1861135733
Name:JURALEWICZ, JOANNA ROSE (LPN, CLC,CPD)
Entity type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:ROSE
Last Name:JURALEWICZ
Suffix:
Gender:F
Credentials:LPN, CLC,CPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 ELM ST
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-4304
Mailing Address - Country:US
Mailing Address - Phone:978-265-1578
Mailing Address - Fax:
Practice Address - Street 1:256 ELM ST
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-4304
Practice Address - Country:US
Practice Address - Phone:978-265-1578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MARN121719OtherRN121719