Basic Information
| Provider Information | |||||||||
| NPI: | 1942530373 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEFFNER | ||||||||
| FirstName: | BRENDA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 161 WASHINGTON STREET, 14TH FL | ||||||||
| Address2: | EIGHT TOWER BRIDGE, SUITE 1400 | ||||||||
| City: | CONSHOHOCKEN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4843513206 | ||||||||
| FaxNumber: | 4844502617 | ||||||||
| Practice Location | |||||||||
| Address1: | 1407 UNION AVE STE 1007 | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381043664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012762357 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2010 | ||||||||
| LastUpdateDate: | 04/22/2019 | ||||||||
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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 | 363LF0000X | 14645 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.