Healthcare Provider Details

I. General information

NPI: 1467226076
Provider Name (Legal Business Name): INYANG MERCY DANIEL AJAMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2023
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 BOSTON RD
NORTH BILLERICA MA
01862-2321
US

IV. Provider business mailing address

221 BOSTON RD
NORTH BILLERICA MA
01862-2321
US

V. Phone/Fax

Practice location:
  • Phone: 978-224-1418
  • Fax: 978-213-8953
Mailing address:
  • Phone: 978-224-1418
  • Fax: 978-213-8953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2312536
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: