Provider Demographics
NPI:1740657576
Name:ST HILAIRE, AIMEE (DNP)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:ST HILAIRE
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:CORMIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:242 GREEN ST
Mailing Address - Street 2:FAVOR 2
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-1336
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:242 GREEN ST
Practice Address - Street 2:FAVOR 2
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-1336
Practice Address - Country:US
Practice Address - Phone:978-630-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2020-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2272560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily