Healthcare Provider Details

I. General information

NPI: 1144814385
Provider Name (Legal Business Name): HEATHER MARIE TREMBLAY MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4015 SW 21ST ST STE 309
TOPEKA KS
66604-3412
US

IV. Provider business mailing address

4015 SW 21ST ST STE 309
TOPEKA KS
66604-3412
US

V. Phone/Fax

Practice location:
  • Phone: 785-447-2064
  • Fax: 785-576-1271
Mailing address:
  • Phone: 785-447-2064
  • Fax: 785-576-1271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-80255
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-80255
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number103494
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: