Provider Demographics
NPI:1902459308
Name:HEFFERNAN, BRITTANY MARIE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:MARIE
Last Name:HEFFERNAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5940 CROMWELL RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-1424
Mailing Address - Country:US
Mailing Address - Phone:248-470-0488
Mailing Address - Fax:
Practice Address - Street 1:5940 CROMWELL RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-1424
Practice Address - Country:US
Practice Address - Phone:248-470-0488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical