Healthcare Provider Details

I. General information

NPI: 1578511002
Provider Name (Legal Business Name): RICHARD FRANCIS HEFNER APRN,CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 03/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 JACKSON AVE
TACOMA WA
98431-1100
US

IV. Provider business mailing address

9040 JACKSON AVE
TACOMA WA
98431-1100
US

V. Phone/Fax

Practice location:
  • Phone: 253-982-7085
  • Fax:
Mailing address:
  • Phone: 253-982-7085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA01137
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: