Healthcare Provider Details

I. General information

NPI: 1558025312
Provider Name (Legal Business Name): AISHA NAIGA KAMOGA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2021
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 LITTLETON RD UNIT 3
CHELMSFORD MA
01824-3429
US

IV. Provider business mailing address

290 LITTLETON RD UNIT 3
CHELMSFORD MA
01824-3429
US

V. Phone/Fax

Practice location:
  • Phone: 978-685-2460
  • Fax:
Mailing address:
  • Phone: 978-685-2460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAG09210191
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN2288782
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: