Healthcare Provider Details

I. General information

NPI: 1447788609
Provider Name (Legal Business Name): HEIDI MARIE KRAUSKOPF FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI MARIE COMPTON FNP-BC

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 SE GREENVILLE AVE
WINCHESTER IN
47394-9464
US

IV. Provider business mailing address

840 N OAK AVE
RULEVILLE MS
38771-3227
US

V. Phone/Fax

Practice location:
  • Phone: 765-584-0480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71017218A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number902041
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: