Provider Demographics
NPI:1447935077
Name:SCHAEFER, HEATHER MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:MARIE
Other - Last Name:HEIBERGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:W3910 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:CHILTON
Mailing Address - State:WI
Mailing Address - Zip Code:53014-9763
Mailing Address - Country:US
Mailing Address - Phone:920-509-9432
Mailing Address - Fax:
Practice Address - Street 1:W3910 SHADY LN
Practice Address - Street 2:
Practice Address - City:CHILTON
Practice Address - State:WI
Practice Address - Zip Code:53014-9763
Practice Address - Country:US
Practice Address - Phone:920-509-9432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program