Individual
NANCY A HEERENS-KNUDSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1330 N SUPERIOR AVE, TOMAH, WI 54660-1130
(608) 372-4111
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
(608) 775-4467
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1744
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41992900
—
WI
Enumeration date
06/20/2005
Last updated
07/08/2007
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