Provider Demographics
NPI:1528943412
Name:BAUER, HEIDI A
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:A
Last Name:BAUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6792 DEMBY RD
Mailing Address - Street 2:
Mailing Address - City:ARENA
Mailing Address - State:WI
Mailing Address - Zip Code:53503-9313
Mailing Address - Country:US
Mailing Address - Phone:608-370-9999
Mailing Address - Fax:
Practice Address - Street 1:557 S WINSTED ST
Practice Address - Street 2:
Practice Address - City:SPRING GREEN
Practice Address - State:WI
Practice Address - Zip Code:53588-9435
Practice Address - Country:US
Practice Address - Phone:608-370-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI333387-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty