Provider Demographics
NPI:1649262262
Name:REED, HEIDI A (CRNA)
Entity type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:A
Last Name:REED
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CHARLES ST
Mailing Address - Street 2:P.O. BOX 146
Mailing Address - City:HILLROSE
Mailing Address - State:CO
Mailing Address - Zip Code:80733-9735
Mailing Address - Country:US
Mailing Address - Phone:970-847-3011
Mailing Address - Fax:
Practice Address - Street 1:2400 EDISON ST
Practice Address - Street 2:
Practice Address - City:BRUSH
Practice Address - State:CO
Practice Address - Zip Code:80723-1640
Practice Address - Country:US
Practice Address - Phone:970-842-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO174285367500000X
NE101137367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO914858410Medicaid
CO32184352Medicaid
CO32184352Medicaid
VTRE VN1702Medicare UPIN
CO807813Medicare PIN