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Individual

HEATHER A LUTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
1405 MILL ST, NEW LONDON, WI 54961-2155
(920) 531-2400
(920) 531-2450
Mailing address
N3456 OAKWOOD PASS, NEW LONDON, WI 54961-8857
(920) 470-1444

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
196046
WI
363LF0000X
Family Nurse Practitioner
Primary
9268
WI

Other

Enumeration date
06/04/2019
Last updated
01/21/2021
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