Provider Demographics
NPI:1427153584
Name:FEENER, JUDY E (NP)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:E
Last Name:FEENER
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 1:31 MANSION DR
Mailing Address - Street 2:
Mailing Address - City:TOPSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01983-1109
Mailing Address - Country:US
Mailing Address - Phone:978-887-3847
Mailing Address - Fax:
Practice Address - Street 1:75 BRIMBAL AVE
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6009
Practice Address - Country:US
Practice Address - Phone:978-490-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA138000363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3039749OtherMASS HEALTH
MAAA59547OtherHARVARD PIGRIM
MAS49470Medicare UPIN
MAAA59547OtherHARVARD PIGRIM