Provider Demographics
NPI:1689220741
Name:WINFIELD, HEATHER RENEE
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:RENEE
Last Name:WINFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:RENEE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:604 25 RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1202
Mailing Address - Country:US
Mailing Address - Phone:970-254-0990
Mailing Address - Fax:970-644-6446
Practice Address - Street 1:604 25 RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1202
Practice Address - Country:US
Practice Address - Phone:970-254-0990
Practice Address - Fax:970-644-6446
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0108697363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner