Provider Demographics
NPI:1053612309
Name:HELLIWELL, JANET LOUISE (NP)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LOUISE
Last Name:HELLIWELL
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 1:770 CONVERSE ST
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1719
Mailing Address - Country:US
Mailing Address - Phone:413-565-2904
Mailing Address - Fax:413-565-2975
Practice Address - Street 1:770 CONVERSE ST
Practice Address - Street 2:
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1719
Practice Address - Country:US
Practice Address - Phone:413-565-2904
Practice Address - Fax:413-565-2975
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN212877363L00000X, 364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
001985701Medicare Oscar/Certification