| NPI | 1962010405 |
|---|---|
| Former Name | ALYSSA HENNIGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2293678) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MA RN2293678) |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2023-05-03 |