Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APN.0994907-NP | CO |
NPI | 1043865793 |
---|---|
Provider Name | Angelina Marie Heuer |
First Address | Centennial, CO 80015-6789 |
Second Address | Colorado Springs, CO 80920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2019 |
Last Update Date | 09/08/2019 |