Pricilia Maze Etta

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN2326823 Issued in MA

Practice address

10 Overlook Ridge Dr Unit 329
Malden, MA 02148-4765

Phone

(857) 247-6674

NPI assigned

Nov 17, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1508523242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 OVERLOOK RIDGE DR UNIT 329",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484765",
            "telephone_number": "857-247-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 OVERLOOK RIDGE DR UNIT 329",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484765",
            "telephone_number": "857-247-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTA",
        "first_name": "PRICILIA",
        "middle_name": "MAZE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2326823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Empire Vision Center Inc
• Cheryl Enos, MS
• Samuel A Esquivel
• Latoya S. Etheridge, M.D.
• Fashiny Etienne
• Eye Care Consultants, Inc.
• Divine C Ezewuzie, RN
• F. a. Carmichael Dentistry, Inc.
• Julianna Marie Fagan
• Yi Fan

• Registered Nurse in Malden, MA
• Providers in Malden, MA by specialty
• Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.