Provider Demographics
NPI:1174808968
Name:SPICCI, JOANNE (RN)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:
Last Name:SPICCI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 MAIDEN LANE
Mailing Address - Street 2:OLYMPIA HIGH SCHOOL
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14615
Mailing Address - Country:US
Mailing Address - Phone:585-966-5005
Mailing Address - Fax:
Practice Address - Street 1:1139 MAIDEN LANE
Practice Address - Street 2:OLYMPIA HIGH SCHOOL
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615
Practice Address - Country:US
Practice Address - Phone:585-966-5005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY511611163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool