Individual
ALISA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
41 MALL RD, BURLINGTON, MA 01805-3050
(781) 744-8000
Mailing address
PROVIDER ENROLLMENT 41 MALL ROAD, BURLINGTON, MA 01805-0001
(781) 744-8085
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
RN2291642
MA
363L00000X
Nurse Practitioner
Primary
RN2291642
MA
363LA2200X
Adult Health Nurse Practitioner
090974-23
NH
363LA2200X
Adult Health Nurse Practitioner
APRN.CNP.0041669
OH
363LA2200X
Adult Health Nurse Practitioner
RN2291642
MA
363LG0600X
Gerontology Nurse Practitioner
RN2291642
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3144055
—
NH
05
—
RN2291642
—
MA
Enumeration date
05/15/2018
Last updated
03/05/2026
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