Healthcare Provider Details

I. General information

NPI: 1336387448
Provider Name (Legal Business Name): HEATHER E. CROTTY MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19711 E SMOKY HILL RD
CENTENNIAL CO
80015-5194
US

IV. Provider business mailing address

8 CADILLAC DR SUITE 250
BRENTWOOD TN
37027-5087
US

V. Phone/Fax

Practice location:
  • Phone: 303-459-5634
  • Fax: 303-459-5635
Mailing address:
  • Phone: 615-425-4200
  • Fax: 615-425-4271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5764
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: