Healthcare Provider Details

I. General information

NPI: 1750992210
Provider Name (Legal Business Name): ERIN HEFFELFINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 MARINA GATEWAY DR APT 1432
SPARKS NV
89434
US

IV. Provider business mailing address

550 MARINA GATEWAY DR APT 1432
SPARKS NV
89434
US

V. Phone/Fax

Practice location:
  • Phone: 919-357-0881
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: