Basic Information
| Provider Information | |||||||||
| NPI: | 1073669842 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAPUT | ||||||||
| FirstName: | ALICE | ||||||||
| MiddleName: | E. | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | R.N., MSN, APRN,BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16 MCKINLEY AVE | ||||||||
| Address2: | |||||||||
| City: | METHUEN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018447109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9786883519 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 EVERETT AVENUE | ||||||||
| Address2: | MGH CHELSEA HEALTH CENTER | ||||||||
| City: | CHELSEA | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178874600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2007 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 88634 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 0341291 | 05 | MA | MEDICAID | NP1314 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER |