Healthcare Provider Details

I. General information

NPI: 1548465370
Provider Name (Legal Business Name): HEIDI HUBER NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8383 W ALAMEDA AVE
LAKEWOOD CO
80226-3007
US

IV. Provider business mailing address

5589 ARGONNE ST
DENVER CO
80249-8989
US

V. Phone/Fax

Practice location:
  • Phone: 303-344-4545
  • Fax:
Mailing address:
  • Phone: 720-516-8805
  • Fax: 720-516-8806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0995128-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberANP0995128
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPN.0995128-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: