Individual
SAN JUANITA HEYTENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1513 W WYATT EARP BLVD, DODGE CITY, KS 67801-3352
(620) 682-8304
Mailing address
1513 W WYATT EARP BLVD, DODGE CITY, KS 67801-3352
(620) 682-8304
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
101659
KS
363LF0000X
Family Nurse Practitioner
Primary
53-81235-122
KS
Other
Enumeration date
07/27/2020
Last updated
01/20/2024
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