Healthcare Provider Details
I. General information
NPI: 1114540960
Provider Name (Legal Business Name): STEFFAINY JESSIE HEFLEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/27/2020
Last Update Date: 02/15/2021
Certification Date: 02/15/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1993 ERRECART BLVD
ELKO NV
89801-8334
US
IV. Provider business mailing address
1993 ERRECART BLVD
ELKO NV
89801-8334
US
V. Phone/Fax
- Phone: 775-753-1049
- Fax: 775-777-8494
- Phone: 775-753-1049
- Fax: 775-777-8494
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: