Provider Demographics
NPI:1215360623
Name:HEWIT, JOHN J (APRN)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:HEWIT
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:55 BEARFOOT RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1513
Mailing Address - Country:US
Mailing Address - Phone:781-421-7940
Mailing Address - Fax:781-421-7949
Practice Address - Street 1:161 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-2010
Practice Address - Country:US
Practice Address - Phone:508-897-5694
Practice Address - Fax:508-897-5533
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN250380363L00000X, 363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner