Provider Demographics
NPI:1396302170
Name:HEFELFINGER, AMANDA GAYLE (RN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:GAYLE
Last Name:HEFELFINGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:GAYLE
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:309 EASY ST
Mailing Address - Street 2:
Mailing Address - City:FRANKSTON
Mailing Address - State:TX
Mailing Address - Zip Code:75763-3247
Mailing Address - Country:US
Mailing Address - Phone:903-253-1721
Mailing Address - Fax:
Practice Address - Street 1:309 EASY ST
Practice Address - Street 2:
Practice Address - City:FRANKSTON
Practice Address - State:TX
Practice Address - Zip Code:75763-3247
Practice Address - Country:US
Practice Address - Phone:903-253-1721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX819088163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse