Provider Demographics
NPI:1184929622
Name:HEFLIN, ANDREA K (APN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:K
Last Name:HEFLIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 MCKNIGHT RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-0929
Mailing Address - Country:US
Mailing Address - Phone:903-718-8808
Mailing Address - Fax:
Practice Address - Street 1:4321 MCKNIGHT RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-0929
Practice Address - Country:US
Practice Address - Phone:903-718-8808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-13
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX582791363LG0600X
TXAP119811363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00927129OtherRAILROAD MEDICARE
AR187954758Medicaid
TX281678701Medicaid
AR4A230GA28Medicare PIN
TX281678701Medicaid