Provider Demographics
NPI:1518606722
Name:HOLLOWAY, HEATHER (CNM)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7108 E LOWRY BLVD APT 2141
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7025
Mailing Address - Country:US
Mailing Address - Phone:903-267-1772
Mailing Address - Fax:
Practice Address - Street 1:9475 BRIAR VILLAGE PT STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7902
Practice Address - Country:US
Practice Address - Phone:719-367-9405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-04
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997282-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife