Healthcare Provider Details

I. General information

NPI: 1427978345
Provider Name (Legal Business Name): THOMAS CHRISTOPHER HEINBOCKEL RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TOM HEINBOCKEL RN

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4747 ARAPAHOE AVE
BOULDER CO
80303-1131
US

IV. Provider business mailing address

4726 FOURMILE CANYON DR
BOULDER CO
80302-9706
US

V. Phone/Fax

Practice location:
  • Phone: 303-473-7400
  • Fax:
Mailing address:
  • Phone: 201-414-7803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1684792
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: