Provider Demographics
NPI:1699812008
Name:AHERN, JULIANNE (PNP)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:AHERN
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:JULIANNE
Other - Middle Name:
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1290 TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:ROXBURY CROSSING
Mailing Address - State:MA
Mailing Address - Zip Code:02120-3432
Mailing Address - Country:US
Mailing Address - Phone:617-427-1000
Mailing Address - Fax:617-989-3068
Practice Address - Street 1:1290 TREMONT ST
Practice Address - Street 2:
Practice Address - City:ROXBURY CROSSING
Practice Address - State:MA
Practice Address - Zip Code:02120-3432
Practice Address - Country:US
Practice Address - Phone:617-427-1000
Practice Address - Fax:617-989-3068
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA262995363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics