Provider Demographics
NPI:1386267334
Name:MA-HEIMAN, MELISSA WANDA (APRN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:WANDA
Last Name:MA-HEIMAN
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:WANDA
Other - Last Name:MA-HEIMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 932958
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3211 S SENECA ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67217-3348
Practice Address - Country:US
Practice Address - Phone:316-670-1582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-98393-032163WE0003X
KS79437363L00000X
OK219617363LF0000X
KS53-79437-032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner