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NPI Code Detail

MEDICARE: MS. AMANDA MARIE HEGEMAN BSN, RN

MEDICARE:  MS. AMANDA MARIE HEGEMAN  BSN, RN
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
1163W00000XRegistered Nurse158907030WI

General Provider Information

NPI Number : 1386952661
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMANDA MARIE HEGEMAN BSN, RN
Provider Business Mailing Address
First Line : 2047 N COMMERCE ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-3484
Country : US
Telephone Number : 414-699-7553
Fax Number :
Provider Business Practice Location Address
First Line : 2047 N COMMERCE ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-3484
Country : US
Telephone Number : 414-699-7553
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2010
Last Update Date : 09/20/2010

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Directions to “ MS. AMANDA MARIE HEGEMAN BSN, RN” Practice Location

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