Provider Demographics
NPI:1093033169
Name:LEUTWYLER, HEATHER (RN, FNP, PHD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:LEUTWYLER
Suffix:
Gender:F
Credentials:RN, FNP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 KORET WAY, BOX 0610
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0610
Mailing Address - Country:US
Mailing Address - Phone:415-341-5344
Mailing Address - Fax:
Practice Address - Street 1:8300 OCEANVIEW TER
Practice Address - Street 2:#404
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-3282
Practice Address - Country:US
Practice Address - Phone:415-341-5344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA651046163W00000X
CA16283363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse