Provider Demographics
NPI:1184303695
Name:HEPBURN, ALRIC LEARD (NP)
Entity type:Individual
Prefix:
First Name:ALRIC
Middle Name:LEARD
Last Name:HEPBURN
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 1:57 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-4835
Mailing Address - Country:US
Mailing Address - Phone:774-417-2140
Mailing Address - Fax:
Practice Address - Street 1:57 ALLEN ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-4835
Practice Address - Country:US
Practice Address - Phone:774-417-2140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA258707363L00000X
MARN258707163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner