Provider Demographics
NPI:1497242168
Name:HEEG MILLER, ELLE CLAIRE
Entity Type:Individual
Prefix:
First Name:ELLE
Middle Name:CLAIRE
Last Name:HEEG MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 N RACE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-4551
Mailing Address - Country:US
Mailing Address - Phone:715-514-9888
Mailing Address - Fax:
Practice Address - Street 1:2611 N RACE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-4551
Practice Address - Country:US
Practice Address - Phone:715-514-9888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0993780-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily