Individual
DR. KATHRYN JEANNE-HENAULT HEAPHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102
(207) 662-0111
(207) 956-6676
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7861
(207) 956-6676
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
274816
MA
2085R0202X
Diagnostic Radiology Physician
Primary
MD22806
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104262013
—
ME
Enumeration date
05/18/2013
Last updated
06/05/2019
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