Provider Demographics
NPI:1396012019
Name:DOWD, HEIDI MARIE (MSN)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:MARIE
Last Name:DOWD
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 1ST AVE W
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-1876
Mailing Address - Country:US
Mailing Address - Phone:715-232-1314
Mailing Address - Fax:
Practice Address - Street 1:103 1ST AVE W
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-1876
Practice Address - Country:US
Practice Address - Phone:715-232-1314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR210763-9363LA2200X
WI4708-33363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health