Individual
HEATHER ANN HALVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1715 DOUSMAN ST, GREEN BAY, WI 54303-3211
(920) 496-4700
(920) 272-1120
Mailing address
PO BOX 19070, PREVEA HEALTH, GREEN BAY, WI 54307-9070
(920) 496-4700
(920) 496-4705
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
117041
WI
363L00000X
Nurse Practitioner
Primary
1789
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43929400
—
WI
Enumeration date
07/19/2006
Last updated
06/16/2015
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