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NPI Code Detail

MEDICARE: MARY K HEIMMERMANN APNP

MEDICARE: MARY K HEIMMERMANN 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 Practitioner3841-033WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578795407
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY K HEIMMERMANN APNP
Provider Business Mailing Address
First Line : 411 LINCOLN ST
Second Line : NETWORK HOUSE CALLS
City : NEENAH
State : WI
Zip : 54956-2753
Country : US
Telephone Number : 920-886-0818
Fax Number : 920-427-1310
Provider Business Practice Location Address
First Line : 411 LINCOLN ST
Second Line : NETWORK HOUSE CALLS
City : NEENAH
State : WI
Zip : 54956-2753
Country : US
Telephone Number : 920-886-0818
Fax Number : 920-427-1310
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2009
Last Update Date : 10/18/2012

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Directions to “ MARY K HEIMMERMANN APNP” Practice Location

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