Healthcare Provider Details

I. General information

NPI: 1386442796
Provider Name (Legal Business Name): KIMBERLY ANN HEFFELFINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 03/04/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7307 PONDEROSA DR
PAPILLION NE
68046-3659
US

IV. Provider business mailing address

7197 PINE ST
OMAHA NE
68106-2811
US

V. Phone/Fax

Practice location:
  • Phone: 402-679-4444
  • Fax:
Mailing address:
  • Phone: 402-838-5693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: