Healthcare Provider Details

I. General information

NPI: 1184261455
Provider Name (Legal Business Name): RACHEL HEFNER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2019
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 N BROOKSIDE RD
SPRINGFIELD PA
19064-2527
US

IV. Provider business mailing address

9 N BROOKSIDE RD
SPRINGFIELD PA
19064-2527
US

V. Phone/Fax

Practice location:
  • Phone: 610-543-5300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP021248
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: