Provider Demographics
NPI:1902629967
Name:ESSEN, HEATHER DAWN
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:DAWN
Last Name:ESSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:DAWN
Other - Last Name:BURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2509 RESEARCH BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-8108
Mailing Address - Country:US
Mailing Address - Phone:970-224-1550
Mailing Address - Fax:
Practice Address - Street 1:2509 RESEARCH BLVD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-8108
Practice Address - Country:US
Practice Address - Phone:970-224-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN1624325163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse