| NPI | 1043634496 |
|---|---|
| Former Name | THERESA J HEISE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5162) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 198769) |
| 363L00000X Nurse Practitioner (Licence: WI 5683) | |
| 363LN0000X Nurse Practitioner, Neonatal (Licence: MN 5162) | |
| 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: WI 5683) | |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2023-05-19 |