Individual
HEATHER A RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 S HERITAGE WOODS DR, APPLETON, WI 54915-1408
(920) 225-7875
(920) 993-5003
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(204) 977-7783
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4920
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100096164
—
WI
Enumeration date
12/27/2019
Last updated
09/24/2023
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