Provider Demographics
NPI:1356341242
Name:FINE, ANNE G (FNP)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:G
Last Name:FINE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:HILLTOWN COMMUNITY HEALTH CENTER
Mailing Address - Street 2:58 OLD NORTH ROAD
Mailing Address - City:WORTHINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01098
Mailing Address - Country:US
Mailing Address - Phone:413-238-5511
Mailing Address - Fax:413-238-5358
Practice Address - Street 1:HILLTOWN COMMUNITY HEALTH CENTER - SCHOOL-BASED PROGRAM
Practice Address - Street 2:12 LITTLEVILLE ROAD
Practice Address - City:HUNTINGTON
Practice Address - State:MA
Practice Address - Zip Code:01050
Practice Address - Country:US
Practice Address - Phone:413-667-0142
Practice Address - Fax:413-667-0145
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA175218363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
(AA)25716OtherHARVARD PILGRIM
175218OtherCONNECTICARE OF MA
043202198OtherGROUP PRACTICE ENROLLMENT
0017467OtherCIGNA
043202198OtherMULTI-PLAN
81158OtherHEALTHY START
MA0702013Medicaid