Provider Demographics
NPI:1306459862
Name:LAFIANZA, ALYCEN GAIL (MSN, CNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ALYCEN
Middle Name:GAIL
Last Name:LAFIANZA
Suffix:
Gender:F
Credentials:MSN, CNP, PMHNP-BC
Other - Prefix:
Other - First Name:ALYCEN
Other - Middle Name:GAIL
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, CNP, PMHNP-BC
Mailing Address - Street 1:1501 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-7599
Mailing Address - Country:US
Mailing Address - Phone:781-328-3011
Mailing Address - Fax:781-328-3011
Practice Address - Street 1:769 PLAIN ST UNIT 1
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-2118
Practice Address - Country:US
Practice Address - Phone:800-852-2844
Practice Address - Fax:617-786-9894
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2287466163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health