Provider Demographics
NPI:1457222671
Name:EMSHOFF, HEATHER
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:EMSHOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 GREEN MEADOW DR APT 3
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-4464
Mailing Address - Country:US
Mailing Address - Phone:920-944-7373
Mailing Address - Fax:
Practice Address - Street 1:3001 GREEN MEADOW DR APT 3
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-4464
Practice Address - Country:US
Practice Address - Phone:920-944-7373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-12
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIE521-3338-5552-07172A00000X
WI372500000X, 372600000X, 3747P1801X, 3747A0650X, 106S00000X
146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No172A00000XOther Service ProvidersDriver
No372500000XNursing Service Related ProvidersChore Provider
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician