Healthcare Provider Details

I. General information

NPI: 1376453613
Provider Name (Legal Business Name): CAROLYN HEINS RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 PEAK ONE DR STE 230
FRISCO CO
80443-5948
US

IV. Provider business mailing address

PO BOX 2280
FRISCO CO
80443-2280
US

V. Phone/Fax

Practice location:
  • Phone: 970-668-9161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.0125682
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: