Provider Demographics
NPI:1912635681
Name:ALCE, CHAMOUNE
Entity Type:Individual
Prefix:
First Name:CHAMOUNE
Middle Name:
Last Name:ALCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHAMOUNE
Other - Middle Name:
Other - Last Name:LOUIMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
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:774-444-9394
Mailing Address - Fax:
Practice Address - Street 1:800 HINGHAM ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:MA
Practice Address - Zip Code:02370-1074
Practice Address - Country:US
Practice Address - Phone:774-444-9394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2278205363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily