Healthcare Provider Details

I. General information

NPI: 1386571339
Provider Name (Legal Business Name): QUEEN ACHOAKAWA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 PALEOLOGOS ST
PEABODY MA
01960-4452
US

IV. Provider business mailing address

29 PALEOLOGOS ST
PEABODY MA
01960-4452
US

V. Phone/Fax

Practice location:
  • Phone: 508-840-7155
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2288856
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2288856
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: