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NPI Code Detail

MEDICARE: HEATHER L. MAYER APNP

MEDICARE: HEATHER L. MAYER APNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner147479-30WI

General Provider Information

NPI Number : 1053579441
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER L. MAYER APNP
Provider Business Mailing Address
First Line : 620 SMITH AVE
Second Line :
City : OCONTO
State : WI
Zip : 54153-1080
Country : US
Telephone Number : 920-834-4110
Fax Number : 920-834-4117
Provider Business Practice Location Address
First Line : 620 SMITH AVE
Second Line :
City : OCONTO
State : WI
Zip : 54153-1080
Country : US
Telephone Number : 920-834-4110
Fax Number : 920-834-4117
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2008
Last Update Date : 06/02/2008

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Directions to “ HEATHER L. MAYER APNP” Practice Location

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