Individual
MS. JENNIFER ANN HEENAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
5320 W MICHAELS DR, APPLETON, WI 54913-8446
(920) 882-8200
(920) 882-8225
Mailing address
100 THEDA CLARK MEDICAL PLZ, STE 400, NEENAH, WI 54956-2763
(920) 725-4527
(920) 729-2378
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
146092-30
WI
363L00000X
Nurse Practitioner
4390-033
WI
363L00000X
Nurse Practitioner
Primary
4390-33
WI
Other
Enumeration date
06/28/2011
Last updated
07/05/2021
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