Sorum, Heather J

Sorum, Heather J is an individual health care provider with primary practice located at 721 American Ave Ste 205 Prohealth Care Diabetes Center, Waukesha WI 53188-5071. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Sorum, Heather J can be contacted via phone (262) 928-4695.

Contact Information

Primary practice address
721 American Ave Ste 205 Prohealth Care Diabetes Center Waukesha WI 53188-5071
Phone: (262) 928-4695
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 2113 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 136222 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 2113 Wisconsin

Profile Details

NPI number 1801850524
LBN Legal business name Sorum, Heather J
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 12th, 2006
Last updated Nov 8th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801850524 NPPES
Wisconsin MEDICAID 43979600

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