Basic Information
| Provider Information | |||||||||
| NPI: | 1649732652 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AHO | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | JEAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 66 TOY TOWN LN | ||||||||
| Address2: | |||||||||
| City: | WINCHENDON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014752802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783057375 | ||||||||
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| Practice Location | |||||||||
| Address1: | 175 CONNORS ST | ||||||||
| Address2: | |||||||||
| City: | GARDNER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014402637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9788788100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2019 | ||||||||
| LastUpdateDate: | 04/01/2019 | ||||||||
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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 | 363LF0000X | RN281629 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.