Provider Demographics
NPI:1407990146
Name:AHMED, ASMA (ANP)
Entity Type:Individual
Prefix:MS
First Name:ASMA
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 MAIN ST
Mailing Address - Street 2:STE 15
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-3753
Mailing Address - Country:US
Mailing Address - Phone:857-203-6200
Mailing Address - Fax:857-203-5738
Practice Address - Street 1:1400 VFW PKWY
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-4927
Practice Address - Country:US
Practice Address - Phone:857-203-6200
Practice Address - Fax:857-203-5738
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA236055363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner