Provider Demographics
NPI:1831734466
Name:HEFFRON, SIERRA DAWN
Entity type:Individual
Prefix:MRS
First Name:SIERRA
Middle Name:DAWN
Last Name:HEFFRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5246 TILDY LN
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-6039
Mailing Address - Country:US
Mailing Address - Phone:208-680-5264
Mailing Address - Fax:
Practice Address - Street 1:5246 TILDY LN
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-6039
Practice Address - Country:US
Practice Address - Phone:208-680-5264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-06
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171400000XOther Service ProvidersHealth & Wellness Coach
No172V00000XOther Service ProvidersCommunity Health Worker