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General NPI Number Information
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NPI Number | 1285886531
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Entity Type | Individual
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Provider Name | HEIDI K WARMBOLD NP
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Gender | Female
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Dates
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Enumeration Date | 10/17/2008
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 5703 MEMORIAL CT
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City | WESTON
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State | WI
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Zip | 54476-6502
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Country | US
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Telephone | 715-204-9808
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Fax | 774-209-4285
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Provider Business Mailing Address
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Address Line | 5703 MEMORIAL CT
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City | WESTON
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State | WI
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Zip | 54476-6502
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Country | US
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Telephone | 843-476-1684
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Fax | 774-209-4285
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10947-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R33773
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License Number State | ND
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