Individual
MS. HEIDI LEIGH HEISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1100 LAKE VIEW DR, WAUSAU, WI 54403-6799
(715) 848-4600
Mailing address
1100 LAKE VIEW DR, WAUSAU, WI 54403-6799
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4214
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4214
WI
Other
Enumeration date
10/19/2010
Last updated
05/04/2021
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