Provider Demographics
NPI:1720463953
Name:FORD, HEATHER S (NP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:S
Last Name:FORD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-2738
Mailing Address - Country:US
Mailing Address - Phone:720-463-1920
Mailing Address - Fax:833-699-2152
Practice Address - Street 1:640 GRAND AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2738
Practice Address - Country:US
Practice Address - Phone:720-463-1920
Practice Address - Fax:833-699-2152
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991862-NP363LA2200X
CO0991862363LG0600X
COAPN0991862363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology