Provider Demographics
NPI:1104136316
Name:HEFLIN, STEPHANIE M (RN, ANP-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:HEFLIN
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Gender:F
Credentials:RN, ANP-C
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Mailing Address - Street 1:10497 TOWN AND COUNTRY WAY
Mailing Address - Street 2:SUITE 360
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1143
Mailing Address - Country:US
Mailing Address - Phone:713-341-2100
Mailing Address - Fax:713-932-7072
Practice Address - Street 1:10497 TOWN AND COUNTRY WAY
Practice Address - Street 2:SUITE 360
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1143
Practice Address - Country:US
Practice Address - Phone:713-341-2100
Practice Address - Fax:713-932-7072
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2011-06-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX249415207QA0505X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00HA28Medicare PIN