Provider Demographics
NPI:1366626301
Name:HEFNER-ERICKSON, KATHE S (CRNP)
Entity Type:Individual
Prefix:
First Name:KATHE
Middle Name:S
Last Name:HEFNER-ERICKSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 LANGHORNE NEWTOWN RD
Mailing Address - Street 2:SUITE 411
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1219
Mailing Address - Country:US
Mailing Address - Phone:215-750-7000
Mailing Address - Fax:215-750-9572
Practice Address - Street 1:261 CHAPMAN RD STE 100
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5426
Practice Address - Country:US
Practice Address - Phone:302-449-7484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009675363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health