Healthcare Provider Details

I. General information

NPI: 1063376150
Provider Name (Legal Business Name): HEARTLAND CENTER FOR REPRODUCTIVE MEDICINE OF KANSAS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 W 110TH ST STE 320
OVERLAND PARK KS
66211-1798
US

IV. Provider business mailing address

7308 S 142ND ST
OMAHA NE
68138-6804
US

V. Phone/Fax

Practice location:
  • Phone: 402-717-4200
  • Fax:
Mailing address:
  • Phone: 402-812-8318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHANIE GUSTIN
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 402-717-4200