Healthcare Provider Details

I. General information

NPI: 1629449566
Provider Name (Legal Business Name): LINDSEY KAUFMANN HEFFNER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY KAUFMANN PA

II. Dates (important events)

Enumeration Date: 10/19/2015
Last Update Date: 01/25/2021
Certification Date: 01/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 CALHOUN ST
CHARLESTON SC
29401
US

IV. Provider business mailing address

PO BOX 601495
CHARLOTTE NC
28260-1495
US

V. Phone/Fax

Practice location:
  • Phone: 843-724-2010
  • Fax: 843-724-2005
Mailing address:
  • Phone: 843-789-1620
  • Fax: 843-724-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number2448
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: