Individual
HEIDI E ECKELBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
4536 22ND AVE, KENOSHA, WI 53140-5917
(262) 656-0044
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2233
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4184
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4184
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100012858
—
WI
Enumeration date
09/29/2010
Last updated
06/27/2023
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