Provider Demographics
NPI:1447382536
Name:HEFFERNAN, SHERYL L (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:L
Last Name:HEFFERNAN
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 1:71 UNION AVE., SUITE 207A
Mailing Address - Street 2:SUPREME HOME HEALTH SERVICES
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070
Mailing Address - Country:US
Mailing Address - Phone:201-372-9600
Mailing Address - Fax:201-372-9550
Practice Address - Street 1:71 UNION AVE SUPREME HOME HEALTH SERVICES,
Practice Address - Street 2:SUITE 207A
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070
Practice Address - Country:US
Practice Address - Phone:201-372-9600
Practice Address - Fax:201-372-9550
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO04727300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse