Provider Demographics
NPI:1144814385
Name:TREMBLAY, HEATHER MARIE (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:TREMBLAY
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 SW 21ST ST STE 309
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3412
Mailing Address - Country:US
Mailing Address - Phone:785-447-2064
Mailing Address - Fax:785-576-1271
Practice Address - Street 1:4015 SW 21ST ST STE 309
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3412
Practice Address - Country:US
Practice Address - Phone:785-447-2064
Practice Address - Fax:785-576-1271
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-80255363L00000X, 363LP0808X
KS103494163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse