Provider Demographics
NPI:1104305796
Name:HENNIGAN, HEIDI ALIE (CPM)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:ALIE
Last Name:HENNIGAN
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3681 S DANUBE CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-3631
Mailing Address - Country:US
Mailing Address - Phone:720-295-2492
Mailing Address - Fax:
Practice Address - Street 1:3681 S DANUBE CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-3631
Practice Address - Country:US
Practice Address - Phone:720-295-2492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
18080007OtherNORTH AMERICAN REGISTRY OF MIDWIVES