Provider Demographics
NPI:1952858185
Name:DUNHAM, HEATHER (APN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:DUNHAM
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 EXEMPLA CIR
Mailing Address - Street 2:SUITE 420
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3397
Mailing Address - Country:US
Mailing Address - Phone:720-565-6101
Mailing Address - Fax:314-536-8764
Practice Address - Street 1:300 EXEMPLA CIR
Practice Address - Street 2:SUITE 420
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3397
Practice Address - Country:US
Practice Address - Phone:720-565-6101
Practice Address - Fax:314-536-8764
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0992559.NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily