Healthcare Provider Details

I. General information

NPI: 1336062827
Provider Name (Legal Business Name): KASEN MARIE HEIM MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 MULBERRY ST
SCRANTON PA
18510-2369
US

IV. Provider business mailing address

282 HILLSIDE AVE
EDWARDSVILLE PA
18704-2319
US

V. Phone/Fax

Practice location:
  • Phone: 570-703-8000
  • Fax:
Mailing address:
  • Phone: 570-406-3431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: