Provider Demographics
NPI:1073405239
Name:IHESIENE, ROSELINE MADUKA (RN)
Entity type:Individual
Prefix:MRS
First Name:ROSELINE
Middle Name:MADUKA
Last Name:IHESIENE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:ROSELINE
Other - Middle Name:CHUKWU
Other - Last Name:MADUKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:442 SAMUEL DR
Mailing Address - Street 2:
Mailing Address - City:WHITINSVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01588-3313
Mailing Address - Country:US
Mailing Address - Phone:774-578-2899
Mailing Address - Fax:
Practice Address - Street 1:442 SAMUEL DR
Practice Address - Street 2:
Practice Address - City:WHITINSVILLE
Practice Address - State:MA
Practice Address - Zip Code:01588-3313
Practice Address - Country:US
Practice Address - Phone:774-578-2899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2315532163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse