Provider Demographics
NPI:1114262623
Name:HEGE, DOROTHY J (RN)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:J
Last Name:HEGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:DOROTHY
Other - Middle Name:HOOVER
Other - Last Name:HEGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:16185 SYRESVILLE LN
Mailing Address - Street 2:
Mailing Address - City:RICHLAND CENTER
Mailing Address - State:WI
Mailing Address - Zip Code:53581-8462
Mailing Address - Country:US
Mailing Address - Phone:608-475-0148
Mailing Address - Fax:
Practice Address - Street 1:16185 SYRESVILLE LN
Practice Address - Street 2:
Practice Address - City:RICHLAND CENTER
Practice Address - State:WI
Practice Address - Zip Code:53581-8462
Practice Address - Country:US
Practice Address - Phone:608-475-0148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI71133-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse