Provider Demographics
NPI:1386842201
Name:WHITE, HEIDI K (PA)
Entity type:Individual
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First Name:HEIDI
Middle Name:K
Last Name:WHITE
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Gender:F
Credentials:PA
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Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
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Mailing Address - Fax:
Practice Address - Street 1:8890 N UNION BLVD STE 170
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-2701
Practice Address - Country:US
Practice Address - Phone:719-364-5005
Practice Address - Fax:719-365-9911
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2025-06-26
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Provider Licenses
StateLicense IDTaxonomies
CAPA19246363A00000X
COPA.0008271363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant