Most Relevant Information
Provider Data
| NPI Number: | 1003440942 |
| Provider Name: | HEATHER KONEN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 150409-30 |
Most Important Dates
| Enumeration Date: | 03/01/2020 |
| Last Updated: | 03/01/2020 |
Provider Practice Location
W2761 POPLAR RD
FOND DU LAC
WI
549376588
Practice Location Phone/Fax
| Phone: | 9202030756 |
| Fax: |
Provider Mailing Location
W2761 POPLAR RD
FOND DU LAC
WI
549376588
Provider Mailing Phone/Fax
| Phone: | 9202030756 |
| Fax: |