Healthcare Provider Details

I. General information

NPI: 1508854647
Provider Name (Legal Business Name): CATHARINE ANNE HEFFERNAN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE ANNE HEFFERNAN CNM MSN

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 FRANKLIN ST
RUMFORD ME
04276-2104
US

IV. Provider business mailing address

172 SHEEPSKIN BOG RD
GREENWOOD ME
04255-3634
US

V. Phone/Fax

Practice location:
  • Phone: 207-369-0146
  • Fax:
Mailing address:
  • Phone: 207-205-1268
  • Fax: 207-624-3845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberCNM82009
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: