Individual
JENNIFER M HEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Mailing address
550 POPE AVE, MUNSON ARMY HEALTH CENTER, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6542
(913) 684-6536
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
23-29487-062
KS
164W00000X
Licensed Practical Nurse
29487
KS
Other
Enumeration date
10/26/2005
Last updated
08/23/2023
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