Healthcare Provider Details

I. General information

NPI: 1144178377
Provider Name (Legal Business Name): HEIDIJO KATHERINE LEACH KRAUSE PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 SILVERNAIL RD
PEWAUKEE WI
53072-5402
US

IV. Provider business mailing address

1231 SCHOFIELD AVE
SCHOFIELD WI
54476-2352
US

V. Phone/Fax

Practice location:
  • Phone: 262-260-9000
  • Fax: 262-260-9109
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number18185
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number18185
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: