Provider Demographics
NPI:1568031946
Name:HECKER, KIM I (DNP, RN)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:I
Last Name:HECKER
Suffix:
Gender:F
Credentials:DNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 S ONEIDA WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2830
Mailing Address - Country:US
Mailing Address - Phone:303-591-2185
Mailing Address - Fax:
Practice Address - Street 1:3220 S ONEIDA WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2830
Practice Address - Country:US
Practice Address - Phone:303-591-2185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1667913163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse