Individual
NICHOLAS JAMES HEEZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2253 W MASON ST, SUITE 200, GREEN BAY, WI 54303-4706
(920) 327-7300
Mailing address
PO BOX 73544, CHICAGO, IL 60673-7544
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
57651
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100027340
—
WI
Enumeration date
10/28/2010
Last updated
12/11/2023
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