Heidi Catherine Puhl
Individual provider Active NPI Driver · South Range, WI
NPI 1164089991 · NPPES record last updated May 28, 2019
Key facts
- NPI
- 1164089991
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 3484 S 22ND Rd
South Range, WI 54874-8849 - Phone
- (218) 428-0377
- NPI assigned
- May 28, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
3484 S 22ND Rd
South Range, WI 54874-8849
Mailing address
3484 S 22ND Rd
South Range, WI 54874-8849
Phone (218) 428-0377
Other providers in South Range, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.