Headrick, Edith Ann
Headrick, Edith Ann is an sole proprietor health care provider with primary practice located at 7525 English Lake Road , Manitowoc WI 54220. She recently has only one registered license in Nursing Service Providers / Pediatrics, which is considered as her primary health care specialty. Headrick, Edith Ann can be contacted via phone (920) 758-3410.Contact Information
Primary practice address
7525 English Lake Road
Manitowoc WI 54220
Phone: (920) 758-3410
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Pediatrics | 163WP0200X | 78218-030 | Wisconsin |
Profile Details
| NPI number | 1750587374 |
|---|---|
| LBN Legal business name | Headrick, Edith Ann |
| Credentials | Registered Nurse (RN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 21st, 2007 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750587374 | NPPES |
| Wisconsin | MEDICAID | 35024500 |
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