Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 251036 | MA |
NPI | 1013993260 |
---|---|
Provider Name | Allison Foley |
First Address | Mattapan, MA 02126-2834 |
Second Address | Dorchester, MA 02122-3134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2005 |
Last Update Date | 09/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q22144 | (02) | MA |