Provider Demographics
NPI:1629037650
Name:HEISE, RHONDA L (APNP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:L
Last Name:HEISE
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 N WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1038
Mailing Address - Country:US
Mailing Address - Phone:608-827-8351
Mailing Address - Fax:
Practice Address - Street 1:1126 N WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1038
Practice Address - Country:US
Practice Address - Phone:608-827-8351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI113639363L00000X
WI1850363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner