Healthcare Provider Details

I. General information

NPI: 1285333948
Provider Name (Legal Business Name): EMMA MUGERWA FNP-BC, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 NEWBURY ST
DANVERS MA
01923-1027
US

IV. Provider business mailing address

9 BARTLET ST STE 2
ANDOVER MA
01810-3655
US

V. Phone/Fax

Practice location:
  • Phone: 978-777-5504
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2325367
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2325367
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: