Individual
AMANDA J HIEMSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1242 W FOND DU LAC ST, RIPON, WI 54971-9288
(920) 745-4700
(920) 745-4701
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6994-33
WI
363LF0000X
Family Nurse Practitioner
6994-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100058649
—
WI
Enumeration date
06/13/2016
Last updated
07/31/2025
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