Payton Heider, RN
Individual provider Active NPI Registered Nurse · Fredonia, WI
NPI 1386469294 · NPPES record last updated Nov 18, 2024
Key facts
- NPI
- 1386469294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 1113810-30 (WI)
- Practice address
- 8426 Stacy Dr
Fredonia, WI 53021-9643 - Phone
- (262) 675-4282
- NPI assigned
- Nov 18, 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
| License | State | Type | Specialty |
|---|---|---|---|
| 1113810-30 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1113810-30 | WI | Yes |
Addresses
Primary practice location
8426 Stacy Dr
Fredonia, WI 53021-9643
Mailing address
8426 Stacy Dr
Fredonia, WI 53021-9643
Phone (262) 675-4282
Other providers in Fredonia, WI
- Dr. David L. Brouillette, D.C., S.C.
- Fredonia Adult Day Center
- Megan Gavin
- Maggie A Graff
- Keri Gregg
- Emma Jacobs
- Allison Johnson
- Melissa J Knous
- Myeyedr Optometry of Wisconsin, LLC
- Michelle M Nave
All providers in Fredonia, WI · Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2024. 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.