Healthcare Provider Details

I. General information

NPI: 1194030445
Provider Name (Legal Business Name): HEIDI DIANE DUMAS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI DIANE DITTMAR FNP

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9940 N COUNTY HWY K
HAYWARD WI
54843
US

IV. Provider business mailing address

PO BOX 331
MINONG WI
54859-0331
US

V. Phone/Fax

Practice location:
  • Phone: 715-638-5100
  • Fax: 715-634-6107
Mailing address:
  • Phone: 715-222-7859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number130820-030
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number103462
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR-130332-4
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number103462
License Number StateMT
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4284-33
License Number StateWI
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number130820-030
License Number StateWI
# 7
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR-130332-4
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: