Provider Demographics
NPI:1346245933
Name:HEATH, ANNEMARIE (CNM)
Entity Type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:
Last Name:HEATH
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ANNEMARIE
Other - Middle Name:
Other - Last Name:HEATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:34 TAMARACK DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2604
Mailing Address - Country:US
Mailing Address - Phone:312-253-7239
Mailing Address - Fax:
Practice Address - Street 1:RIVERBEND MEDICAL GROUP
Practice Address - Street 2:444 MONTEGOMERY DR
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020
Practice Address - Country:US
Practice Address - Phone:413-598-7414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA188095367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife