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NPI Code Detail

MEDICARE: MISS ELIZABETH ANNA HEINITZ OTR

MEDICARE: MISS ELIZABETH ANNA HEINITZ OTR
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
1225X00000XOccupational Therapist2876-26WI

General Provider Information

NPI Number : 1093605875
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ELIZABETH ANNA HEINITZ OTR
Provider Business Mailing Address
First Line : 6541 MARINER DR UNIT 7
Second Line :
City : MOUNT PLEASANT
State : WI
Zip : 53406-5643
Country : US
Telephone Number : 262-687-7647
Fax Number : 262-687-7600
Provider Business Practice Location Address
First Line : 4328 OLD GREEN BAY RD
Second Line :
City : MOUNT PLEASANT
State : WI
Zip : 53403-9489
Country : US
Telephone Number : 262-687-7647
Fax Number : 262-687-7600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2025
Last Update Date : 07/03/2025

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