Basic Information
| Provider Information | |||||||||
| NPI: | 1780124115 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEFFELFINGER | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | IVY | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2116 FERNBROOK DR NE | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358112405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2566583168 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 201 SIVLEY RD SW | ||||||||
| Address2: | STE 500 | ||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358015134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2562653880 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2017 | ||||||||
| LastUpdateDate: | 03/04/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 1-145909 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.