Healthcare Provider Details
I. General information
NPI: 1265312680
Provider Name (Legal Business Name): ALYSSA FRANZOSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/05/2025
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
54 CUMBERLAND ST STE 5
BRUNSWICK ME
04011-1829
US
IV. Provider business mailing address
211 HILLSIDE RD
BRUNSWICK ME
04011-7356
US
V. Phone/Fax
- Phone: 207-406-4218
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WL0100X |
| Taxonomy | Lactation Consultant (Registered Nurse) |
| License Number | RN76041 |
| License Number State | ME |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WL0100X |
| Taxonomy | Lactation Consultant (Registered Nurse) |
| License Number | L-319481 |
| License Number State | ME |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: