Healthcare Provider Details

I. General information

NPI: 1821005315
Provider Name (Legal Business Name): HEIDI M MCCOTTER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4597
US

IV. Provider business mailing address

777 BANNOCK ST
DENVER CO
80204-4597
US

V. Phone/Fax

Practice location:
  • Phone: 720-423-5170
  • Fax: 720-423-5011
Mailing address:
  • Phone: 720-423-5170
  • Fax: 720-423-5011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License NumberAPN.0003248-NP
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberAPN.0003248-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: