Healthcare Provider Details

I. General information

NPI: 1104647585
Provider Name (Legal Business Name): LINDSEY HEFNER RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2024
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 N 1ST ST
YAKIMA WA
98901-2303
US

IV. Provider business mailing address

331 N 1ST ST
YAKIMA WA
98901-2303
US

V. Phone/Fax

Practice location:
  • Phone: 509-573-5002
  • Fax: 509-573-5050
Mailing address:
  • Phone: 509-573-5002
  • Fax: 509-573-5050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN61444994
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: