Provider Demographics
NPI:1710125398
Name:SCHELKE, HEIDI LEIGH (RN)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:LEIGH
Last Name:SCHELKE
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 1:1901 TAMARACK ST
Mailing Address - Street 2:
Mailing Address - City:PLOVER
Mailing Address - State:WI
Mailing Address - Zip Code:54467-2017
Mailing Address - Country:US
Mailing Address - Phone:715-252-8189
Mailing Address - Fax:
Practice Address - Street 1:1901 TAMARACK ST
Practice Address - Street 2:
Practice Address - City:PLOVER
Practice Address - State:WI
Practice Address - Zip Code:54467-2017
Practice Address - Country:US
Practice Address - Phone:715-252-8189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI153514-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse