Provider Demographics
NPI:1154128676
Name:HEFLEY, JONATHAN BAILEY (APRN)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:BAILEY
Last Name:HEFLEY
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 N CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-4453
Mailing Address - Country:US
Mailing Address - Phone:870-741-8559
Mailing Address - Fax:
Practice Address - Street 1:306 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-4453
Practice Address - Country:US
Practice Address - Phone:870-741-8559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR121497363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily