Heather Marie Renee Deiter, RN

Individual provider Active NPI Registered Nurse · Deerfield, WI

NPI 1043046147 · NPPES record last updated Sep 13, 2024

Key facts

NPI
1043046147
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
228840 (WI)
Practice address
1515 Hommen Rd
Deerfield, WI 53531-9678
Phone
(608) 444-0774
NPI assigned
Sep 13, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
228840WIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse
Group: 193400000X SINGLE SPECIALTY GROUP
163W00000X 228840 WI Yes

Addresses

Primary practice location

1515 Hommen Rd
Deerfield, WI 53531-9678

Mailing address

411 Park View Rd
Deerfield, WI 53531-9548
Phone (920) 728-4441

Other providers in Deerfield, WI

All providers in Deerfield, WI · Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.