Provider Demographics
NPI:1457504896
Name:VARTANIAN, HEATHER K (APNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:K
Last Name:VARTANIAN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:K
Other - Last Name:SEUBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:788 N JEFFERSON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-3710
Mailing Address - Country:US
Mailing Address - Phone:414-272-8950
Mailing Address - Fax:414-274-6250
Practice Address - Street 1:13133 N PORT WASHINGTON RD STE 204
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53097-2420
Practice Address - Country:US
Practice Address - Phone:262-243-2524
Practice Address - Fax:262-243-2525
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3548-033363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health