Healthcare Provider Details

I. General information

NPI: 1235616731
Provider Name (Legal Business Name): HEIDI MARIE PIFER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8244 E US HIGHWAY 36 STE 1310
AVON IN
46123-9627
US

IV. Provider business mailing address

8244 E US HIGHWAY 36 STE 1310
AVON IN
46123-9627
US

V. Phone/Fax

Practice location:
  • Phone: 317-838-9355
  • Fax: 317-718-2955
Mailing address:
  • Phone: 317-838-9355
  • Fax: 317-718-2955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28202322A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71008319A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: