Healthcare Provider Details

I. General information

NPI: 1932392677
Provider Name (Legal Business Name): COLLEEN E. AMMIDOWN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COLLEEN E. CUNNINGHAM FNP

II. Dates (important events)

Enumeration Date: 08/27/2007
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 WALNUT ST
FOXBOROUGH MA
02035-5312
US

IV. Provider business mailing address

70 WALNUT ST
FOXBOROUGH MA
02035-5312
US

V. Phone/Fax

Practice location:
  • Phone: 508-543-6371
  • Fax: 508-772-1678
Mailing address:
  • Phone: 508-543-6371
  • Fax: 508-772-1678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number258453
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN258453
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: