Healthcare Provider Details

I. General information

NPI: 1861305278
Provider Name (Legal Business Name): ALLEN NAKINTU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 MILFORD ST
UPTON MA
01568-1309
US

IV. Provider business mailing address

30 DREXEL ST
WORCESTER MA
01602-1238
US

V. Phone/Fax

Practice location:
  • Phone: 508-422-8095
  • Fax: 508-422-9644
Mailing address:
  • Phone: 781-354-3717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLN102055
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: