Individual
HEATHER MEEUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
825 WALTON DR, PLYMOUTH, WI 53073-5022
(920) 893-0903
Mailing address
825 WALTON DR, PLYMOUTH, WI 53073-5022
(920) 893-0903
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
172850-30
WI
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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