Provider Demographics
NPI:1104384478
Name:HEFFNER, CHRISTINE RENEE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:RENEE
Last Name:HEFFNER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 N CR 300E
Mailing Address - Street 2:
Mailing Address - City:CENTER POINT
Mailing Address - State:IN
Mailing Address - Zip Code:47840
Mailing Address - Country:US
Mailing Address - Phone:812-835-5512
Mailing Address - Fax:
Practice Address - Street 1:730 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLAY CITY
Practice Address - State:IN
Practice Address - Zip Code:47841
Practice Address - Country:US
Practice Address - Phone:812-939-2173
Practice Address - Fax:812-939-2508
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016049A1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric