Basic Information
Provider Information
NPI: 1417924986
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VANIHINGER
FirstName: ALICIA
MiddleName: ANN
NamePrefix: MRS.
NameSuffix:  
Credential: APRN-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 362 N BEDFORD ST
Address2:  
City: EAST BRIDGEWATER
State: MA
PostalCode: 023331148
CountryCode: US
TelephoneNumber: 5083502350
FaxNumber: 5083502318
Practice Location
Address1: 1 COMPASS WAY
Address2: SUTIE 200
City: EAST BRIDGEWATER
State: MA
PostalCode: 023331465
CountryCode: US
TelephoneNumber: 5083502300
FaxNumber: 5083502309
Other Information
ProviderEnumerationDate: 03/03/2006
LastUpdateDate: 03/10/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X254591MAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


Home