Provider Demographics
NPI:1588454508
Name:CANTWELL, JOANNA AXELSON (RN)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:AXELSON
Last Name:CANTWELL
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 1:123 BLACKBERRY INN RD
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-9710
Mailing Address - Country:US
Mailing Address - Phone:907-617-8566
Mailing Address - Fax:
Practice Address - Street 1:10 3RD AVE NE STE 200
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5044
Practice Address - Country:US
Practice Address - Phone:828-327-8105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC344262163W00000X
NC153533367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse