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General NPI Number Information
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NPI Number | 1407801806
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Entity Type | Individual
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Provider Name | ANN BERNADETTE HEINTZELMAN ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 4101 S 4TH ST
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5014
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Country | US
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Telephone | 913-682-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 34002 243RD ST
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City | EASTON
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State | KS
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Zip | 66020-7119
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Country | US
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Telephone | 913-773-8652
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 45328
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License Number State | KS
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