Healthcare Provider Details

I. General information

NPI: 1194640185
Provider Name (Legal Business Name): ARMELLE M ANE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 WILLIAM T MORRISSEY BLVD UNIT 1312
DORCHESTER MA
02125-3360
US

IV. Provider business mailing address

1509 WOOD LN
MADISON WI
53705-1456
US

V. Phone/Fax

Practice location:
  • Phone: 608-698-1307
  • Fax:
Mailing address:
  • Phone: 608-698-1307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: