Individual provider Active NPI

Heather Suzanne Krenn

  • Nurse Practitioner
  • Fond Du Lac, WI
National Provider Identifier
1144027749
Registry record updated Mar 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
16578-33 Issued in WI
Practice address
430 E Division St
Fond Du Lac, WI 54935-4560
Phone
(920) 926-8200
NPI assigned
Mar 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 16578-33 WI Primary

Addresses

Primary practice location

430 E Division St
Fond Du Lac, WI 54935-4560

Mailing address

430 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250805003468 WI Practitioner - Nurse Practitioner 3678081189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

430 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 929-2300

Hospital & facility affiliations

  • SSM Health St Agnes Hospital-Fond Du Lac Hospital, Fond Du Lac, WI, CCN 520088
  • Waupun Memorial Hospital Hospital, Waupun, WI, CCN 521327
  • Ripon Medical Center Hospital, Ripon, WI, CCN 521321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16578-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agnesian Healthcare Inc CurrentSince Jun 25, 2025 Accepting new patients
Agnesian Healthcare Inc CurrentSince Jun 25, 2025 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients

Locations

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

Interoperability endpoints

  • Direct secure messaging: hperry330829@direct-ehr-ssmhc.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740787200000",
    "number": "1144027749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRENN",
        "first_name": "HEATHER",
        "middle_name": "SUZANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-01",
        "last_updated": "2025-03-01",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "16578-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.