Healthcare Provider Details

I. General information

NPI: 1730975657
Provider Name (Legal Business Name): ANDREW J HEIN PARAMEDIC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

549 E WILSON ST
MILWAUKEE WI
53207-1635
US

IV. Provider business mailing address

1337 SUNNY RIDGE RD APT 4
PEWAUKEE WI
53072-3835
US

V. Phone/Fax

Practice location:
  • Phone: 414-264-2355
  • Fax:
Mailing address:
  • Phone: 262-442-0655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number70107933
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: