Provider Demographics
NPI:1881349140
Name:OWUSU-ANSAH, ALFRED (DNP)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:
Last Name:OWUSU-ANSAH
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 DEER RUN
Mailing Address - Street 2:
Mailing Address - City:CHARLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01507-1577
Mailing Address - Country:US
Mailing Address - Phone:508-612-4881
Mailing Address - Fax:
Practice Address - Street 1:19 DEER RUN
Practice Address - Street 2:
Practice Address - City:CHARLTON
Practice Address - State:MA
Practice Address - Zip Code:01507-1577
Practice Address - Country:US
Practice Address - Phone:508-612-4881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAG02220081363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology