Provider Demographics
NPI:1538123203
Name:UNKE, HEIDI LYNN (RN)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:LYNN
Last Name:UNKE
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 1:28601 TAMARACK TRL
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53185-3554
Mailing Address - Country:US
Mailing Address - Phone:262-514-3641
Mailing Address - Fax:
Practice Address - Street 1:8547 FRANCIS WAY
Practice Address - Street 2:
Practice Address - City:WIND LAKE
Practice Address - State:WI
Practice Address - Zip Code:53185-1557
Practice Address - Country:US
Practice Address - Phone:262-895-3261
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse