Provider Demographics
NPI:1760846414
Name:HEFT, RACHEL (NP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HEFT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:390 MAPLE SUMMIT RD
Mailing Address - Street 2:
Mailing Address - City:JERSEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62052
Mailing Address - Country:US
Mailing Address - Phone:618-498-8467
Mailing Address - Fax:618-639-2017
Practice Address - Street 1:220 E COUNTY RD
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052
Practice Address - Country:US
Practice Address - Phone:618-498-8467
Practice Address - Fax:618-639-2017
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016007952363L00000X
IL209014148363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner