Healthcare Provider Details

I. General information

NPI: 1003627027
Provider Name (Legal Business Name): HEIDI K DEVEAU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI K LORENZEN

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

S24W26249 WINDEMERE DR
WAUKESHA WI
53188-5512
US

IV. Provider business mailing address

S24W26249 WINDEMERE DR
WAUKESHA WI
53188-5512
US

V. Phone/Fax

Practice location:
  • Phone: 414-640-0882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number15828
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: