Healthcare Provider Details

I. General information

NPI: 1699152942
Provider Name (Legal Business Name): CATHERINE HEFLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 05/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2545 E TUDOR RD
ANCHORAGE AK
99507-1130
US

IV. Provider business mailing address

1935 ORCA PL
ANCHORAGE AK
99501-5707
US

V. Phone/Fax

Practice location:
  • Phone: 907-562-8384
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number632
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number6221
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: