Provider Demographics
NPI:1326233305
Name:MARSH, HEATHER (ARNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:MARSH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N CARRIAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-4501
Mailing Address - Country:US
Mailing Address - Phone:316-962-3125
Mailing Address - Fax:316-962-7656
Practice Address - Street 1:620 N CARRIAGE PKWY
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-4501
Practice Address - Country:US
Practice Address - Phone:316-962-3125
Practice Address - Fax:316-962-1886
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46059363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily