Individual
HEATHER MARIE HODKIEWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8000
Mailing address
PO BOX 735041, CHICAGO, IL 60673-5041
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10581
WI
363LA2100X
Acute Care Nurse Practitioner
158641-30
WI
363LF0000X
Family Nurse Practitioner
10581
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100177763
—
WI
Enumeration date
07/12/2021
Last updated
05/04/2023
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