Provider Demographics
NPI:1316124209
Name:SCARSELLA, HEIDI MARIE (RD)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:MARIE
Last Name:SCARSELLA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:HEIDI
Other - Middle Name:MARIE
Other - Last Name:FRAZIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8900 W 135TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-2040
Mailing Address - Country:US
Mailing Address - Phone:913-685-3500
Mailing Address - Fax:
Practice Address - Street 1:8900 W 135TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66221-2040
Practice Address - Country:US
Practice Address - Phone:913-685-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002975133V00000X
KS1828133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered