Diane G Heatley
Pediatric Otolaryngology
3050 Bosshard Dr
Fitchburg
, Wisconsin 53711-5860
Diane G Heatley
Pediatric Otolaryngology
3050 Bosshard Dr
Fitchburg
, Wisconsin 53711-5860
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About
Features
Specialties
- Pediatric Otolaryngology
Languages spoken
- English
Location
First Address
- Diane G Heatley
- 3050 Bosshard Dr
- Fitchburg, WI
- Zip : 53711-5860
- Phone :
Second Address
- Diane G Heatley
- 3050 Bosshard Dr
- Fitchburg, WI
- Zip : 53711-5860
- Phone : (608) 273-0375
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YP0228X | Pediatric Otolaryngology | 29448-20 | WI |
National Provider Identifier
| NPI | 1396793444 |
|---|---|
| Provider Name | Diane G Heatley |
| First Address | Fitchburg, WI 53711-5860 |
| Second Address | Fitchburg, WI 53711-5860 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/05/2006 |
| Last Update Date | 25/05/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.