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NPI Code Detail

MEDICARE: KIRSTEN VANDENHEUVEL PA-C

MEDICARE: KIRSTEN VANDENHEUVEL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1477401115
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRSTEN VANDENHEUVEL PA-C
Provider Business Mailing Address
First Line : 7601 W JEFFERSON BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4133
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7601 W JEFFERSON BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4133
Country : US
Telephone Number : 260-436-8686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2026
Last Update Date : 03/18/2026

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Directions to “ KIRSTEN VANDENHEUVEL PA-C” Practice Location

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