Provider Demographics
NPI:1184458051
Name:HEINE, TAMARA LYNN (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:LYNN
Last Name:HEINE
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33867 BLACK BEAR RD
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:KS
Mailing Address - Zip Code:66401-9013
Mailing Address - Country:US
Mailing Address - Phone:785-313-5518
Mailing Address - Fax:
Practice Address - Street 1:901 S KANSAS AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66612-1210
Practice Address - Country:US
Practice Address - Phone:802-857-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-31
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-83547-052363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily