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NPI Code Detail

MEDICARE: HEATHER SHOFFNER

MEDICARE:   HEATHER  SHOFFNER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-25-461379TN

General Provider Information

NPI Number : 1902797319
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER SHOFFNER
Provider Business Mailing Address
First Line : 9038 CROSS PARK DR STE 105
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-4729
Country : US
Telephone Number : 865-394-6612
Fax Number : 865-315-7014
Provider Business Practice Location Address
First Line : 9038 CROSS PARK DR STE 105
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-4729
Country : US
Telephone Number : 865-394-6612
Fax Number : 865-315-7014
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2025
Last Update Date : 03/12/2026

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Directions to “ HEATHER SHOFFNER ” Practice Location

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