ROSETTE WAKANABO RN NPI 1629788906

NPI Information

  • NPI: 1629788906
  • Provider Name: ROSETTE WAKANABO, RN
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3214 MAIN CAMPUS DR
    LEXINGTON, MA
    ZIP 02421
  • Phone: (508) 371-8503

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NPI Details

Rosette Wakanabo, RN is a psychiatric/mental health nurse practitioner in Lexington, MA with 2 years of experience. Rosette Wakanabo, RN NPI is 1629788906. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3214 MAIN CAMPUS DR
LEXINGTON, MA
ZIP 02421-627
Phone: (508) 371-8503

The NPI 1629788906 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/28/2022 and was last updated on 2/24/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered NurseRN2320331MASSACHUSETTSNo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthRN2320331MASSACHUSETTSYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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