Provider Demographics
NPI:1578509196
Name:HEYRMAN, JULIE A (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:HEYRMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:HEYRMAN-COMPERNOLLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:180 KNIGHTS WAY
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-8027
Mailing Address - Country:US
Mailing Address - Phone:920-922-5433
Mailing Address - Fax:
Practice Address - Street 1:180 KNIGHTS WAY
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-8027
Practice Address - Country:US
Practice Address - Phone:920-922-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI41673207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP00460099OtherRR MEDICARE
WI34052400Medicaid
WI01994-0035Medicare PIN
WI34052400Medicaid
WIP00460099OtherRR MEDICARE