Provider Demographics
NPI:1063236990
Name:HENDRICKSON, HEATHER (CPNP-PC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HENDRICKSON
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5261 E 131ST DR
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2327
Mailing Address - Country:US
Mailing Address - Phone:720-256-8140
Mailing Address - Fax:
Practice Address - Street 1:5261 E 131ST DR
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-2327
Practice Address - Country:US
Practice Address - Phone:720-256-8140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN-0999984-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics