Healthcare Provider Details

I. General information

NPI: 1174139281
Provider Name (Legal Business Name): JOY ANNE SAFO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AKOSUA AWISI SAFO

II. Dates (important events)

Enumeration Date: 09/23/2020
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 NEWTON ST
SOUTHBOROUGH MA
01772-1215
US

IV. Provider business mailing address

5 NEPONSET ST FL CENTER12
WORCESTER MA
01606-2714
US

V. Phone/Fax

Practice location:
  • Phone: 508-460-3190
  • Fax: 508-460-3279
Mailing address:
  • Phone: 85-460-3190
  • Fax: 508-460-3279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN248379
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN10014945
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: