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General NPI Number Information
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NPI Number | 1386267334
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Entity Type | Individual
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Provider Name | MELISSA WANDA MA-HEIMAN APRN
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Gender | Female
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 3211 S SENECA ST
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City | WICHITA
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State | KS
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Zip | 67217-3348
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Country | US
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Telephone | 316-670-1582
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932958
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City | CLEVELAND
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State | OH
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Zip | 44193-0028
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 13-98393-032
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 79437
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 219617
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-79437-032
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License Number State | KS
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