Healthcare Provider Details

I. General information

NPI: 1649262262
Provider Name (Legal Business Name): HEIDI A REED CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 08/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 EDISON ST
BRUSH CO
80723-1640
US

IV. Provider business mailing address

301 CHARLES ST P.O. BOX 146
HILLROSE CO
80733-9735
US

V. Phone/Fax

Practice location:
  • Phone: 970-842-6200
  • Fax:
Mailing address:
  • Phone: 970-847-3011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number174285
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number101137
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: