Provider Demographics
NPI:1104041151
Name:HERSHEY, JUDITH LILLIAN (NP)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:LILLIAN
Last Name:HERSHEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 CIDER HILL LN
Mailing Address - Street 2:
Mailing Address - City:SHERBORN
Mailing Address - State:MA
Mailing Address - Zip Code:01770-1400
Mailing Address - Country:US
Mailing Address - Phone:508-653-3091
Mailing Address - Fax:
Practice Address - Street 1:100 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2809
Practice Address - Country:US
Practice Address - Phone:781-453-5414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA141337363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology