Provider Demographics
NPI:1831240936
Name:ZUTZ, HEATHER RAE (APNP, GNP)
Entity type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:RAE
Last Name:ZUTZ
Suffix:
Gender:F
Credentials:APNP, GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 E OLIVE ST APT 301
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2051
Mailing Address - Country:US
Mailing Address - Phone:414-708-1430
Mailing Address - Fax:
Practice Address - Street 1:10701 W RESEARCH DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3452
Practice Address - Country:US
Practice Address - Phone:414-708-1430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2588-033363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology