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NPI Code Detail

MEDICARE: MS. HEIDI JO MUNCY PA

MEDICARE: MS. HEIDI JO MUNCY PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant626CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00893501OTHERCORAIL ROAD MEDICARE

General Provider Information

NPI Number : 1073615001
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HEIDI JO MUNCY PA
Provider Business Mailing Address
First Line : 7625 W 92ND AVE
Second Line :
City : WESTMINSTER
State : CO
Zip : 80021-4567
Country : US
Telephone Number : 303-427-4075
Fax Number : 303-423-4185
Provider Business Practice Location Address
First Line : 7625 W 92ND AVE
Second Line :
City : WESTMINSTER
State : CO
Zip : 80021-4567
Country : US
Telephone Number : 303-427-4075
Fax Number : 303-423-4185
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2006
Last Update Date : 05/07/2021

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Directions to “ MS. HEIDI JO MUNCY PA” Practice Location

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