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General NPI Number Information
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NPI Number | 1730147000
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Entity Type | Individual
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Provider Name | HEATHER BOURKOVSKI DO
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Gender | Female
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 2525 N 8TH ST STE 202
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City | GRAND JUNCTION
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State | CO
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Zip | 81501
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Country | US
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Telephone | 970-245-1168
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Fax | 970-242-4299
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Provider Business Mailing Address
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Address Line | 2160 PEREGRINE CT
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City | GRAND JUNCTION
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State | CO
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Zip | 81507-8794
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Country | US
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Telephone | 970-628-5840
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Fax | 970-255-9641
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | O-0371
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 50461
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License Number State | CO
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