Provider Demographics
NPI:1154767713
Name:HECKL, JULIA (RN)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:HECKL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:BOERSCHINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:425 MANOR DR
Mailing Address - Street 2:
Mailing Address - City:SURING
Mailing Address - State:WI
Mailing Address - Zip Code:54174-9182
Mailing Address - Country:US
Mailing Address - Phone:920-842-4132
Mailing Address - Fax:920-842-4133
Practice Address - Street 1:425 MANOR DR
Practice Address - Street 2:
Practice Address - City:SURING
Practice Address - State:WI
Practice Address - Zip Code:54174-9182
Practice Address - Country:US
Practice Address - Phone:920-842-4132
Practice Address - Fax:920-842-4133
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI186053-30163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41536700Medicaid
WI527275Medicare PIN