Doctor Name: | MR. KEVY WIJAYA |
NPI Number: | 1366730202 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | N.P. |
License Number: | 98501 |
Business Practice Address: | 55 Lock St New Haven, CT - 065113603 |
Business Phone Number: | 2034320206 |
Business Fax Number: | |
Mailing Address: | 1620 Kempton St Se Unit 302, OLYMPIA |
State: | WA |
Postal Code: | 985017504 |
Phone Number: | 5019938939 |
Fax Number: | |
NPI Enumeration Date: | 07/13/2011 |
NPI Last Update Date: | 12/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163W00000X |
License Number: | 98501 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N. |