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General NPI Number Information
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NPI Number | 1306195649
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Entity Type | Individual
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Provider Name | ANNA MARIA HEINDL LPN
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Gender | Female
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Dates
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Enumeration Date | 08/31/2012
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Last Update Date | 08/31/2012
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Provider Practice Location Address
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Address Line | 13105 WATERTOWN PLANK RD
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City | ELM GROVE
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State | WI
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Zip | 53122-2213
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Country | US
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Telephone | 262-754-4481
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Fax |
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Provider Business Mailing Address
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Address Line | 1614 VICTORIA DR
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City | WAUKESHA
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State | WI
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Zip | 53189-7413
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Country | US
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Telephone | 262-894-8065
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Fax |
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 31136031
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License Number State | WI
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