Provider Demographics
NPI:1972268357
Name:HEFFNER, ERIN LYNNE (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:LYNNE
Last Name:HEFFNER
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2765 MARGESSON XING
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909-8092
Mailing Address - Country:US
Mailing Address - Phone:765-366-7343
Mailing Address - Fax:
Practice Address - Street 1:2765 MARGESSON XING
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47909-8092
Practice Address - Country:US
Practice Address - Phone:765-366-7343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INNA363LG0600X, 363LA2100X, 363LA2200X
IN71011950A363LG0600X, 208M00000X
IN123456363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health