Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 65314 | WI |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 65314 | WI |
NPI | 1548279896 |
---|---|
Provider Name | Christine A Heisler |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 28/01/2021 |