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Individual

ANGELA MARIE HEINKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2601 FIELDCREST DR, KAUKAUNA, WI 54130-4523
(920) 462-6100
Mailing address
2601 FIELDCREST DR, KAUKAUNA, WI 54130-4523
(920) 462-6100

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4210
WI
363AM0700X
Medical Physician Assistant
Primary
4210
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100071560
WI
Enumeration date
09/17/2017
Last updated
11/03/2023
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