Provider Demographics
NPI:1043252869
Name:BORSARI, HEATHER CHITTENDEN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:CHITTENDEN
Last Name:BORSARI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:H
Other - Last Name:CHITTENDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1804 E PAVILION PL
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5795
Mailing Address - Country:US
Mailing Address - Phone:970-249-6670
Mailing Address - Fax:970-252-1372
Practice Address - Street 1:1804 E PAVILION PL
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401
Practice Address - Country:US
Practice Address - Phone:970-249-6670
Practice Address - Fax:970-252-1372
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001564363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
591697Medicare UPIN