Provider Demographics
NPI:1710668215
Name:HARLAN, HEATHER LEE (ACNP-AP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LEE
Last Name:HARLAN
Suffix:
Gender:F
Credentials:ACNP-AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 MESA ENCANTADA
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-3811
Mailing Address - Country:US
Mailing Address - Phone:602-694-3785
Mailing Address - Fax:
Practice Address - Street 1:2911 JUNCTION ST
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4134
Practice Address - Country:US
Practice Address - Phone:970-247-2215
Practice Address - Fax:970-259-6534
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0998882-NP363LA2100X, 363LG0600X
NM74702363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care