Individual
THERESA HEWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
248 MCHENRY ST, BURLINGTON, WI 53105-1828
(262) 767-8000
(262) 767-8190
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
112517
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100005135
—
WI
Enumeration date
08/04/2009
Last updated
08/12/2024
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