Individual
ALICE WAITHAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1075 WESTFORD ST STE 203, LOWELL, MA 01851-2845
(978) 455-8735
Mailing address
1075 WESTFORD ST, LOWELL, MA 01851-2845
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2304118
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN2304118
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN2304118
NP LICENSE
MA
Enumeration date
08/11/2022
Last updated
05/28/2025
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