Individual
DR. ANN MARIE HEASLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
317 KNUTSON DR, MADISON, WI 53704-1133
(608) 301-1822
Mailing address
315 GRAND AVE, MADISON, WI 53705-3731
(608) 238-3259
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
36456-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3229800
—
WI
Enumeration date
06/26/2006
Last updated
12/10/2024
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