Provider Demographics
NPI:1992350870
Name:HETZEL, HILARY ANNE (APNP)
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:ANNE
Last Name:HETZEL
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:HILARY
Other - Middle Name:ANNE
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7222
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:N63W23231 MAIN ST
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089-3208
Practice Address - Country:US
Practice Address - Phone:262-785-7720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9489363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F06193000OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS