Provider Demographics
NPI:1457598963
Name:RAMSDELL, HEIDI RACHELLE (PT)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:RACHELLE
Last Name:RAMSDELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:RACHELLE
Other - Last Name:LINDQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:823 BELKNAP ST
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880
Mailing Address - Country:US
Mailing Address - Phone:218-590-2328
Mailing Address - Fax:
Practice Address - Street 1:823 BELKNAP ST
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-2960
Practice Address - Country:US
Practice Address - Phone:218-590-2328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11155-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN64-23290OtherMEDICA
WI40192300Medicaid
MN1B411CEOtherBCBS
WI40192300Medicaid