Individual
HEATHER KONEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
W2761 POPLAR RD, FOND DU LAC, WI 54937-6588
(920) 203-0756
Mailing address
W2761 POPLAR RD, FOND DU LAC, WI 54937-6588
(920) 203-0756
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
150409-30
WI
Other
Enumeration date
03/01/2020
Last updated
03/01/2020
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