Provider Demographics
NPI:1255579108
Name:SYKORA, HEIDI A (RN, GNP-BC, APNP)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:A
Last Name:SYKORA
Suffix:
Gender:F
Credentials:RN, GNP-BC, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 W. WELLS ST
Mailing Address - Street 2:MILWAUKEE CENTER FOR INDEPENDENCE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233
Mailing Address - Country:US
Mailing Address - Phone:414-431-7416
Mailing Address - Fax:414-755-1885
Practice Address - Street 1:2020 W WELLS ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-2720
Practice Address - Country:US
Practice Address - Phone:414-431-7416
Practice Address - Fax:414-755-1885
Is Sole Proprietor?:No
Enumeration Date:2009-01-30
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2365363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1255579108OtherNPI
WIQ43278Medicare UPIN