Provider Demographics
NPI:1659742161
Name:SCOTT, HEATHER (PA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:125 RAMPART WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6429
Mailing Address - Country:US
Mailing Address - Phone:720-858-7550
Mailing Address - Fax:720-858-7615
Practice Address - Street 1:340 E 1ST AVE STE 100
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020
Practice Address - Country:US
Practice Address - Phone:303-428-6089
Practice Address - Fax:303-412-2141
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2018-06-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
COPA.0004351363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical