Provider Demographics
NPI:1770172025
Name:CAPPS, HEATHER LEANN (CPHT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LEANN
Last Name:CAPPS
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LEANN
Other - Last Name:ORTLIP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPHT
Mailing Address - Street 1:10633 RENE ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-4052
Mailing Address - Country:US
Mailing Address - Phone:913-661-0100
Mailing Address - Fax:913-906-9098
Practice Address - Street 1:10633 RENE ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-4052
Practice Address - Country:US
Practice Address - Phone:913-661-0100
Practice Address - Fax:913-906-9098
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-07709183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician