Provider Demographics
NPI:1043456668
Name:WINGFIELD, HEIDI MCNUTT (MS)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:MCNUTT
Last Name:WINGFIELD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5114 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-3008
Mailing Address - Country:US
Mailing Address - Phone:970-396-2047
Mailing Address - Fax:970-396-2047
Practice Address - Street 1:14140 FAIRWAY LN
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-9564
Practice Address - Country:US
Practice Address - Phone:303-425-3213
Practice Address - Fax:303-466-9772
Is Sole Proprietor?:No
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist