Individual
HEATHER A KEITEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1718 N 3RD ST, SHEBOYGAN, WI 53081-2805
(920) 627-0139
Mailing address
1718 N 3RD ST, SHEBOYGAN, WI 53081-2805
(920) 627-0139
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
151529-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35010000
—
WI
Enumeration date
09/26/2007
Last updated
09/26/2007
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