Provider Demographics
NPI:1811547011
Name:HEFRIGHT, KIRSTEN MICHELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:MICHELLE
Last Name:HEFRIGHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:MICHELLE
Other - Last Name:WOODFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:814-375-4200
Mailing Address - Fax:814-375-4232
Practice Address - Street 1:145 HOSPITAL AVE STE 211
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1464
Practice Address - Country:US
Practice Address - Phone:814-375-2070
Practice Address - Fax:814-375-2076
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA060990363AS0400X, 363AM0700X
PAOA004985363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical