Healthcare Provider Details

I. General information

NPI: 1932921491
Provider Name (Legal Business Name): DEBORAH ANN HEFFINGTON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 WOODSIDE EXECUTIVE CT STE 310
AIKEN SC
29803-3831
US

IV. Provider business mailing address

575 TELEGRAPH DR
AIKEN SC
29801-5370
US

V. Phone/Fax

Practice location:
  • Phone: 803-226-0343
  • Fax: 803-226-0584
Mailing address:
  • Phone: 803-226-0343
  • Fax: 803-226-0584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number29542
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: