Provider Demographics
NPI:1861814709
Name:SELLS, HEATHER RENEE' (CNA, HHA,)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:RENEE'
Last Name:SELLS
Suffix:
Gender:F
Credentials:CNA, HHA,
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:RENEE'
Other - Last Name:FIKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:1315 S KANSAS ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-3622
Mailing Address - Country:US
Mailing Address - Phone:316-304-9077
Mailing Address - Fax:
Practice Address - Street 1:1315 S KANSAS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-3622
Practice Address - Country:US
Practice Address - Phone:316-304-9077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS118694374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide