Healthcare Provider Details

I. General information

NPI: 1952924888
Provider Name (Legal Business Name): ANNAPURNA HEGDE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 10/26/2025
Certification Date: 10/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 MAIN ST
ANDOVER MA
01810-3846
US

IV. Provider business mailing address

68 MAIN ST
ANDOVER MA
01810-3846
US

V. Phone/Fax

Practice location:
  • Phone: 978-470-0542
  • Fax:
Mailing address:
  • Phone: 978-470-0542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPRN10002943
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF05200522
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: