Provider Demographics
NPI:1225082100
Name:HEIMAN, HEATHER J (APRN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:J
Last Name:HEIMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 N SKYVIEW ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-1146
Mailing Address - Country:US
Mailing Address - Phone:316-312-0002
Mailing Address - Fax:316-854-5644
Practice Address - Street 1:2020 N TYLER RD
Practice Address - Street 2:STE 112
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-4905
Practice Address - Country:US
Practice Address - Phone:316-312-0002
Practice Address - Fax:316-854-5644
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45582363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200266600EMedicaid
KSQ13133Medicare UPIN