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Individual

EMMA IREAN HEENAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
W4762 GOLF COURSE DR, FOND DU LAC, WI 54935-9016
(920) 251-6541
Mailing address
W4762 GOLF COURSE DR, FOND DU LAC, WI 54935-9016

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
238955-30
WI
164X00000X
Licensed Vocational Nurse
312094-31
WI

Other

Enumeration date
05/14/2012
Last updated
03/07/2018
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