Provider Demographics
NPI:1538940564
Name:ALERT, MAAME PANFOA (RN)
Entity type:Individual
Prefix:
First Name:MAAME
Middle Name:PANFOA
Last Name:ALERT
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 1:10 MICHAEL RD
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-2050
Mailing Address - Country:US
Mailing Address - Phone:978-996-1812
Mailing Address - Fax:
Practice Address - Street 1:365 EAST ST
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-1950
Practice Address - Country:US
Practice Address - Phone:978-851-7321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2353528163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse