Provider Demographics
NPI:1548279896
Name:HEISLER, CHRISTINE A (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:HEISLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4287 GILS WAY
Mailing Address - Street 2:
Mailing Address - City:CROSS PLAINS
Mailing Address - State:WI
Mailing Address - Zip Code:53528-8864
Mailing Address - Country:US
Mailing Address - Phone:616-206-5016
Mailing Address - Fax:
Practice Address - Street 1:4287 GILS WAY
Practice Address - Street 2:
Practice Address - City:CROSS PLAINS
Practice Address - State:WI
Practice Address - Zip Code:53528-8864
Practice Address - Country:US
Practice Address - Phone:616-206-5016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI65314207V00000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN160002592Medicare ID - Type Unspecified
MN936695000Medicaid
MNI58612Medicare UPIN