Healthcare Provider Details

I. General information

NPI: 1275032476
Provider Name (Legal Business Name): ALICE MUI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2018
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 HARTFORD AVE
JOHNSTON RI
02919-7109
US

IV. Provider business mailing address

14 GRAFTON ST
QUINCY MA
02169-6909
US

V. Phone/Fax

Practice location:
  • Phone: 401-351-2750
  • Fax: 401-351-6613
Mailing address:
  • Phone: 857-222-0305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN02077
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2314172
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: