Healthcare Provider Details

I. General information

NPI: 1386571339
Provider Name (Legal Business Name): QUEEN ACHOAKAWA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 TUMPIKE STREET, SUITE 26A
CANTON MA
02021
US

IV. Provider business mailing address

1017 TUMPIKE STREET, SUITE 26A SUITE 26A
CANTON MA
02021
US

V. Phone/Fax

Practice location:
  • Phone: 508-840-7155
  • Fax:
Mailing address:
  • Phone: 508-840-7155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2288856
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2288856
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: