Individual
MS. HEATHER ANN COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9200 W WISCONSIN AVE, CARDIOTHORACIC SURGERY, MILWAUKEE, WI 53226-3522
(414) 955-6900
(414) 955-6204
Mailing address
9200 W WISCONSIN AVE, CARDIOTHORACIC SURGERY, MILWAUKEE, WI 53226-3522
(414) 955-6900
(414) 955-6204
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
3397-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508261942
—
WI
Enumeration date
10/28/2014
Last updated
11/18/2022
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