Healthcare Provider Details

I. General information

NPI: 1154771244
Provider Name (Legal Business Name): COLLEEN ERIN GORMAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 WHITING ST
HINGHAM MA
02043-3717
US

IV. Provider business mailing address

195 WHITING ST
HINGHAM MA
02043-3717
US

V. Phone/Fax

Practice location:
  • Phone: 508-231-9064
  • Fax: 781-222-3881
Mailing address:
  • Phone: 508-231-9064
  • Fax: 781-222-3881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN250610
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: