Healthcare Provider Details

I. General information

NPI: 1184303695
Provider Name (Legal Business Name): ALRIC LEARD HEPBURN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 ALLEN ST
NEW BEDFORD MA
02740-4835
US

IV. Provider business mailing address

57 ALLEN ST
NEW BEDFORD MA
02740-4835
US

V. Phone/Fax

Practice location:
  • Phone: 774-417-2140
  • Fax:
Mailing address:
  • Phone: 774-417-2140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number258707
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License NumberRN258707
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: