Provider Demographics
NPI:1679549000
Name:HELLER, FAYE (APRN/CNS)
Entity type:Individual
Prefix:
First Name:FAYE
Middle Name:
Last Name:HELLER
Suffix:
Gender:F
Credentials:APRN/CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 SW 28TH ST
Mailing Address - Street 2:STE. C
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2302
Mailing Address - Country:US
Mailing Address - Phone:785-273-4908
Mailing Address - Fax:785-273-0465
Practice Address - Street 1:5040 SW 28TH ST
Practice Address - Street 2:STE. C
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2302
Practice Address - Country:US
Practice Address - Phone:785-273-4908
Practice Address - Fax:785-273-0465
Is Sole Proprietor?:No
Enumeration Date:2006-02-25
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74019363LP0808X
IL209004413363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS160593OtherPTAN -ISSUED BT KS MEDICARE/BCBS
KS100249920BMedicaid
KS100249920BMedicaid