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Individual

AMY HEIDENREICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3000
Mailing address
1655 N MAYFAIR RD UNIT 26912, WAUWATOSA, WI 53226-4933

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6585-33
WI

Other

Enumeration date
01/16/2019
Last updated
09/26/2021
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