Provider Demographics
NPI:1225642655
Name:HEPPNER, JESSICA FAITH (CPM)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:FAITH
Last Name:HEPPNER
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 N 88TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-3649
Mailing Address - Country:US
Mailing Address - Phone:970-381-9633
Mailing Address - Fax:262-203-5239
Practice Address - Street 1:7106 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213-1811
Practice Address - Country:US
Practice Address - Phone:262-432-3142
Practice Address - Fax:262-203-5239
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-02
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI291-49176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife