=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508854647
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CATHARINE ANNE HEFFERNAN CNM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/12/2005
-----------------------------------------------------
Last Update Date | 11/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 430 FRANKLIN ST
-----------------------------------------------------
City | RUMFORD
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04276-2104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-369-0146
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 172 SHEEPSKIN BOG RD
-----------------------------------------------------
City | GREENWOOD
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04255-3634
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-205-1268
-----------------------------------------------------
Fax | 207-624-3845
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LX0001X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
-----------------------------------------------------
License Number | CNM82009
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------