Provider Demographics
NPI:1194030445
Name:DUMAS, HEIDI DIANE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:DIANE
Last Name:DUMAS
Suffix:
Gender:
Credentials:NP-C
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:DIANE
Other - Last Name:DITTMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 331
Mailing Address - Street 2:
Mailing Address - City:MINONG
Mailing Address - State:WI
Mailing Address - Zip Code:54859-0331
Mailing Address - Country:US
Mailing Address - Phone:715-222-7859
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 331
Practice Address - Street 2:
Practice Address - City:MINONG
Practice Address - State:WI
Practice Address - Zip Code:54859-0331
Practice Address - Country:US
Practice Address - Phone:715-222-7859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT103462207Q00000X, 363LF0000X
WI4284-33363LF0000X
MNR-130332-4363LF0000X, 163W00000X
WI130820-030363LF0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163W00000XNursing Service ProvidersRegistered Nurse