Provider Demographics
NPI:1831437508
Name:HARTMANN, HEATHER D (APNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:D
Last Name:HARTMANN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:D
Other - Last Name:WEGENKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3301 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2843
Mailing Address - Country:US
Mailing Address - Phone:414-389-2233
Mailing Address - Fax:
Practice Address - Street 1:7137 236TH AVE STE 106
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:WI
Practice Address - Zip Code:53168-8975
Practice Address - Country:US
Practice Address - Phone:262-558-5995
Practice Address - Fax:262-558-5045
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5218363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner