Provider Demographics
NPI:1033547138
Name:STROBL, HEATHER (RN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:STROBL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N RICHMOND ST
Mailing Address - Street 2:UNIT 322
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-4654
Mailing Address - Country:US
Mailing Address - Phone:715-360-6836
Mailing Address - Fax:
Practice Address - Street 1:400 N RICHMOND ST
Practice Address - Street 2:UNIT 322
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-4654
Practice Address - Country:US
Practice Address - Phone:715-360-6836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI176975030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse