Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APN.0991105-NP | CO |
NPI | 1003233479 |
---|---|
Provider Name | Mrs. Heather A Elliott |
First Address | Rocky Ford, CO 81067-1328 |
Second Address | Rocky Ford, CO 81067-1328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2014 |
Last Update Date | 15/10/2015 |