Phionah Mutebi Nakityo Sr.

Individual provider Active NPI Licensed Practical Nurse · Upton, MA

NPI 1992532824 · NPPES record last updated Sep 16, 2024

Key facts

NPI
1992532824
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LN953264 (MA)
Practice address
11 Maple Ave
Upton, MA 01568-1654
Phone
(857) 498-4536
NPI assigned
Sep 16, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LN953264MAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Global Dynamics Lifecare Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LN953264 MA Yes

Addresses

Primary practice location

11 Maple Ave
Upton, MA 01568-1654

Mailing address

11 Maple Ave
Upton, MA 01568-1654
Phone (857) 498-4536

Other providers in Upton, MA

All providers in Upton, MA · Licensed Practical Nurse in Massachusetts

Sources for this page

Verify at the official NPI Registry.