Basic Information
| Provider Information | |||||||||
| NPI: | 1508854647 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEFFERNAN | ||||||||
| FirstName: | CATHARINE | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 149 MAIN ST, STE 2A | ||||||||
| Address2: | WINTHROP FAMILY PRACTICE - MGMC MIDWIFERY SERVICES | ||||||||
| City: | WINTHROP | ||||||||
| State: | ME | ||||||||
| PostalCode: | 04364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076243800 | ||||||||
| FaxNumber: | 2076243845 | ||||||||
| Practice Location | |||||||||
| Address1: | 149 MAIN ST, STE 2A | ||||||||
| Address2: | WINTHROP FAMILY PRACTICE - MGMC MIDWIFERY SERVICES | ||||||||
| City: | WINTHROP | ||||||||
| State: | ME | ||||||||
| PostalCode: | 04364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076243800 | ||||||||
| FaxNumber: | 2076243845 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2005 | ||||||||
| LastUpdateDate: | 11/26/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | AM082009 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 5892611 | 01 | ME | CIGNA | OTHER | 510524452 | 01 | ME | MEDNET | OTHER | AA26161 | 01 | MA | HARVARD PILGRAM | OTHER | 047918 | 01 | ME | ANTHEM MANAGED CARE | OTHER | 251880099 | 05 | ME | MEDICAID | 5365632 | 01 | ME | NON HMO AETNA | OTHER | 047918 | 01 | ME | ANTHEM BC/BS | OTHER | 3699646 | 01 | ME | HMO AETNA | OTHER |