Provider Demographics
NPI:1134653314
Name:HEFNER, ASHLEY E (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:E
Last Name:HEFNER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:E
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA C
Mailing Address - Street 1:PO BOX 643398
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-3398
Mailing Address - Country:US
Mailing Address - Phone:513-221-1100
Mailing Address - Fax:513-569-5297
Practice Address - Street 1:7661 BEECHMONT AVE STE 240
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4243
Practice Address - Country:US
Practice Address - Phone:513-221-1100
Practice Address - Fax:513-865-9046
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004995RX363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1043274418Medicaid