Individual
KATHLEEN HEFFERNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
258 MAIN ST STE B1, BOURNE, MA 02532-3251
(857) 263-3758
Mailing address
258 MAIN ST STE B1, BOURNE, MA 02532-3251
(508) 317-5900
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN143164
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN143164
MA
Other
Enumeration date
08/03/2020
Last updated
07/14/2022
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