Hietpas, Jill Marie
Hietpas, Jill Marie is an individual health care provider with primary practice located at 1835 E Edgewood Dr Ste 10535 , Appleton WI 54913-9407. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Hietpas, Jill Marie can be contacted via phone (920) 215-0102.Contact Information
Primary practice address
1835 E Edgewood Dr Ste 10535
Appleton WI 54913-9407
Phone: (920) 215-0102
Fax: (920) 214-0795
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1285023 | Wisconsin |
Profile Details
| NPI number | 1396796660 |
|---|---|
| LBN Legal business name | Hietpas, Jill Marie |
| Credentials | PA C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2006 |
| Last updated | Oct 26th, 2023 - about 2 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 | 1396796660 | NPPES |
| Wisconsin | MEDICAID | 32494700 |
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