Healthcare Provider Details

I. General information

NPI: 1942112917
Provider Name (Legal Business Name): ALAINA MARIA GOODWIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 1ST AVE FL 6
CHARLESTOWN MA
02129-3109
US

IV. Provider business mailing address

9 BEVERLY HL
CANTON MA
02021-3124
US

V. Phone/Fax

Practice location:
  • Phone: 781-571-8010
  • Fax:
Mailing address:
  • Phone: 781-571-8010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2366395
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: