Healthcare Provider Details

I. General information

NPI: 1356380240
Provider Name (Legal Business Name): BRANDI LYNN HEFFELFINGER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRANDI STEFFEN CNP

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3358 RIDGEWOOD RD
FAIRLAWN OH
44333-3118
US

IV. Provider business mailing address

3358 RIDGEWOOD RD
FAIRLAWN OH
44333-3118
US

V. Phone/Fax

Practice location:
  • Phone: 330-665-1455
  • Fax:
Mailing address:
  • Phone: 330-665-1455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP-07499
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: