Provider Demographics
NPI:1497981393
Name:HEFLIN, REBECCA KAY (FNP)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:KAY
Last Name:HEFLIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 ALLEN ST
Mailing Address - Street 2:STE 403
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4570
Mailing Address - Country:US
Mailing Address - Phone:802-772-4414
Mailing Address - Fax:802-772-7973
Practice Address - Street 1:278 VT ROUTE 149
Practice Address - Street 2:
Practice Address - City:WEST PAWLET
Practice Address - State:VT
Practice Address - Zip Code:05775-9798
Practice Address - Country:US
Practice Address - Phone:802-645-0580
Practice Address - Fax:802-645-0587
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRINPP37879363LF0000X
VT101-0047022363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1016551Medicaid
VTY400325390Medicare PIN