MEDICARE: HEATHER RENEE DILLARD

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	18492-33	WI

General Provider Information

NPI Number	:	1548196314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER RENEE DILLARD

Provider Business Mailing Address
First Line	:	2004 HIGHLAND AVE STE 2B
Second Line	:
City	:	EAU CLAIRE
State	:	WI
Zip	:	54701-4389
Country	:	US
Telephone Number	:	715-317-5466
Fax Number	:

Provider Business Practice Location Address
First Line	:	2004 HIGHLAND AVE STE 2B
Second Line	:
City	:	EAU CLAIRE
State	:	WI
Zip	:	54701-4389
Country	:	US
Telephone Number	:	715-317-5466
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2026
Last Update Date	:	06/22/2026

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Directions to “ HEATHER RENEE DILLARD ” Practice Location

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