Provider Demographics
NPI:1376853598
Name:MAUCHER, HEATHER L (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:L
Last Name:MAUCHER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 N CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1160
Mailing Address - Country:US
Mailing Address - Phone:719-635-7321
Mailing Address - Fax:719-381-4426
Practice Address - Street 1:2940 N CIRCLE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1160
Practice Address - Country:US
Practice Address - Phone:719-635-7321
Practice Address - Fax:719-381-4426
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN-175645163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse