Provider Demographics
NPI:1467094581
Name:WATTERS, HEATHER R (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:R
Last Name:WATTERS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 E HARMONY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-9631
Mailing Address - Country:US
Mailing Address - Phone:303-929-4875
Mailing Address - Fax:
Practice Address - Street 1:2580 E HARMONY RD STE 101
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-9631
Practice Address - Country:US
Practice Address - Phone:303-929-4875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0995097363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily