Provider Demographics
NPI:1194511790
Name:ASARE, AMMA BOAA (PMHNP)
Entity type:Individual
Prefix:
First Name:AMMA
Middle Name:BOAA
Last Name:ASARE
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MCINTYRE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01507-5124
Mailing Address - Country:US
Mailing Address - Phone:774-922-2350
Mailing Address - Fax:
Practice Address - Street 1:12 MCINTYRE RD
Practice Address - Street 2:
Practice Address - City:CHARLTON
Practice Address - State:MA
Practice Address - Zip Code:01507-5124
Practice Address - Country:US
Practice Address - Phone:774-922-2350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2275876363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health