Healthcare Provider Details

I. General information

NPI: 1528265493
Provider Name (Legal Business Name): HEIDI RENEE VINCENT NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 02/11/2020
Certification Date: 02/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E HAMPDEN AVE
ENGLEWOOD CO
80113-2702
US

IV. Provider business mailing address

7618 S CROCKER CT
LITTLETON CO
80120-4404
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-6515
  • Fax:
Mailing address:
  • Phone: 720-220-2633
  • Fax: 303-721-8087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number123945
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: