Provider Demographics
NPI:1780089730
Name:HEFNER, ANDRIA M (APRN)
Entity type:Individual
Prefix:MS
First Name:ANDRIA
Middle Name:M
Last Name:HEFNER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:ANDRIA
Other - Middle Name:M
Other - Last Name:DOWNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 636961
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6961
Mailing Address - Country:US
Mailing Address - Phone:513-981-5130
Mailing Address - Fax:513-981-5015
Practice Address - Street 1:1530 LONE OAK RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7901
Practice Address - Country:US
Practice Address - Phone:270-444-2150
Practice Address - Fax:270-444-2985
Is Sole Proprietor?:No
Enumeration Date:2014-11-01
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009064363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100318880Medicaid
KY7100318880Medicaid