Healthcare Provider Details

I. General information

NPI: 1023898335
Provider Name (Legal Business Name): VIRTUAL SLEEP SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N9254 LAURA ST
APPLETON WI
54915-2898
US

IV. Provider business mailing address

N9254 LAURA ST
APPLETON WI
54915-2898
US

V. Phone/Fax

Practice location:
  • Phone: 920-944-9321
  • Fax: 920-944-2352
Mailing address:
  • Phone: 920-944-2321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KELSEY HEATH
Title or Position: NURSE PRACTITIONER
Credential:
Phone: 920-740-2813