Healthcare Provider Details

I. General information

NPI: 1255579108
Provider Name (Legal Business Name): HEIDI A SYKORA RN, GNP-BC, APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2009
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W WELLS ST
MILWAUKEE WI
53233-2720
US

IV. Provider business mailing address

2020 W. WELLS ST MILWAUKEE CENTER FOR INDEPENDENCE
MILWAUKEE WI
53233
US

V. Phone/Fax

Practice location:
  • Phone: 414-431-7416
  • Fax: 414-755-1885
Mailing address:
  • Phone: 414-431-7416
  • Fax: 414-755-1885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number2365
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: