Healthcare Provider Details

I. General information

NPI: 1851763643
Provider Name (Legal Business Name): JESSICA HEFFELFINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA ZIMMERMAN

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 02/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 DAVE'S WAY
HAMBURG PA
19526-3096
US

IV. Provider business mailing address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 610-628-7206
  • Fax: 610-628-7216
Mailing address:
  • Phone: 484-526-6048
  • Fax: 833-213-6428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP015480
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: