Provider Demographics
NPI:1427276088
Name:HEFNER, LARA (RN)
Entity type:Individual
Prefix:
First Name:LARA
Middle Name:
Last Name:HEFNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1918
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-1918
Mailing Address - Country:US
Mailing Address - Phone:614-888-8237
Mailing Address - Fax:614-888-8256
Practice Address - Street 1:5550 GLENDON CT #360
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017
Practice Address - Country:US
Practice Address - Phone:614-888-8237
Practice Address - Fax:614-888-8256
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN223457163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management