Individual
MELINDA HEUTINCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C, ARNP
Contact information
Practice address
1504 NE 96TH ST STE A, LIBERTY, MO 64068-1351
(816) 415-2233
(816) 415-2218
Mailing address
1504 NE 96TH ST STE A, LIBERTY, MO 64068-1351
(816) 415-2233
(816) 415-2218
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
146726
MO
363LW0102X
Women's Health Nurse Practitioner
Primary
146726
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110035
BCBS KS GROUP
KS
01
—
06215024
BCBS KCMO GROUP
MO
01
—
09841048
BCBS KCMO
MO
01
—
146726
MO STATE BOARD OF NURSING
MO
Enumeration date
03/21/2008
Last updated
03/20/2026
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