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Individual

MRS. ALEKSANDRA MAIA BACON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
A-GNP-C

Contact information

Practice address
37 FRIEND ST, LYNN, MA 01902-3068
(978) 513-7300
Mailing address
30 POLK ST UNIT 303, CHARLESTOWN, MA 02129-1995
(802) 343-1986

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN2330670
MA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
09/02/2022
Last updated
12/13/2022
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