Individual
HEATHER L FAUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215
(414) 649-6000
Mailing address
2901 W KINNICKINNIC RIVER PKWY STE 305, MILWAUKEE, WI 53215-3660
(414) 385-2590
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3139
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100030629
—
WI
Enumeration date
06/10/2013
Last updated
03/22/2022
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