Provider Demographics
NPI:1255037594
Name:CONNORS, HEATHER ROANNA (RN, MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ROANNA
Last Name:CONNORS
Suffix:
Gender:F
Credentials:RN, MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 NORTH RD STE 3450
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-1183
Mailing Address - Country:US
Mailing Address - Phone:978-722-4109
Mailing Address - Fax:
Practice Address - Street 1:144 NORTH RD STE 3450
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-1183
Practice Address - Country:US
Practice Address - Phone:978-722-4109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2375961363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health