Basic Information
Provider Information
NPI: 1386672400
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EHRET
FirstName: ANN NORA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 57 PORTLAND ST
Address2: SUITE 2A
City: SOUTH BERWICK
State: ME
PostalCode: 039081203
CountryCode: US
TelephoneNumber: 2073849212
FaxNumber: 2073842008
Practice Location
Address1: 57 PORTLAND ST
Address2: SUITE 2A
City: SOUTH BERWICK
State: ME
PostalCode: 039081203
CountryCode: US
TelephoneNumber: 2073849212
FaxNumber: 2073842008
Other Information
ProviderEnumerationDate: 06/29/2006
LastUpdateDate: 11/29/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X3074AKN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000X2259MEY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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