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General NPI Number Information
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NPI Number | 1437212727
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Entity Type | Individual
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Provider Name | HEATHER HACK FNP
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 02/11/2016
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Provider Practice Location Address
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Address Line | 1024 CENTRAL PARK DR
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City | STEAMBOAT SPRINGS
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State | CO
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Zip | 80487-8813
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Country | US
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Telephone | 970-870-1086
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Fax |
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Provider Business Mailing Address
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Address Line | 34780 COUNTRY GREEN RD
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City | STEAMBOAT SPRINGS
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State | CO
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Zip | 80487-9300
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Country | US
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Telephone | 720-985-3721
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 169161
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License Number State | CO
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