Provider Demographics
NPI:1669820601
Name:ALCE, FABIENNE (RN)
Entity Type:Individual
Prefix:
First Name:FABIENNE
Middle Name:
Last Name:ALCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:FABIENNE
Other - Middle Name:A
Other - Last Name:CHIRAC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:54 PROVOST ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-2828
Mailing Address - Country:US
Mailing Address - Phone:508-345-4085
Mailing Address - Fax:
Practice Address - Street 1:17 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-3323
Practice Address - Country:US
Practice Address - Phone:508-345-4085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11030144363LP0808X
TX1154434363LP0808X
NYF405556-01363LP0808X
MARN2306543163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health