Healthcare Provider Details

I. General information

NPI: 1659262012
Provider Name (Legal Business Name): KAYLA MARIE HEISER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 DEAK DR
SMYRNA DE
19977-1268
US

IV. Provider business mailing address

38 DEAK DR
SMYRNA DE
19977-1268
US

V. Phone/Fax

Practice location:
  • Phone: 302-261-5600
  • Fax: 302-653-9563
Mailing address:
  • Phone: 302-261-5600
  • Fax: 302-653-9563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberLJ-0010507
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: