Healthcare Provider Details

I. General information

NPI: 1366146391
Provider Name (Legal Business Name): KAITLYN HEYRMAN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 S COMMERCIAL ST
NEENAH WI
54956-4801
US

IV. Provider business mailing address

1511 S COMMERCIAL ST
NEENAH WI
54956-4801
US

V. Phone/Fax

Practice location:
  • Phone: 920-720-0660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number623212
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: