Provider Demographics
NPI:1386044576
Name:HEIN, WENDY (RN, CPNP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:HEIN
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:MCCLELLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CPNP
Mailing Address - Street 1:2401 GILLHAM RD
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-4619
Mailing Address - Country:US
Mailing Address - Phone:816-302-6808
Mailing Address - Fax:816-855-1700
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-4619
Practice Address - Country:US
Practice Address - Phone:816-302-6808
Practice Address - Fax:816-855-1700
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014022532363LP0200X
KS5376372071363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics