Healthcare Provider Details

I. General information

NPI: 1245166545
Provider Name (Legal Business Name): BASSEY MAINA
Entity Type: Individual
Gender:
Sole Proprietor: Y

Provider Other Name: KATE MAINA

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

581 FAUNCE CORNER RD
DARTMOUTH MA
02747-1242
US

IV. Provider business mailing address

581 FAUNCE CORNER RD
DARTMOUTH MA
02747-1242
US

V. Phone/Fax

Practice location:
  • Phone: 774-259-8548
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2320915
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: