Provider Demographics
NPI:1821106634
Name:GAUGHAN, ANNE REGINA (RN BSN)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:REGINA
Last Name:GAUGHAN
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 NORMAN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01510-3422
Mailing Address - Country:US
Mailing Address - Phone:978-365-9329
Mailing Address - Fax:
Practice Address - Street 1:45 SUMMER ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3228
Practice Address - Country:US
Practice Address - Phone:978-534-6116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77926163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult