Provider Demographics
NPI:1871398727
Name:LIM, HEEYAE JENNIFER (PMHNP)
Entity type:Individual
Prefix:
First Name:HEEYAE
Middle Name:JENNIFER
Last Name:LIM
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19590 E MAINSTREET STE 202
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7371
Mailing Address - Country:US
Mailing Address - Phone:720-383-7095
Mailing Address - Fax:
Practice Address - Street 1:19590 E MAINSTREET STE 202
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7371
Practice Address - Country:US
Practice Address - Phone:720-383-7095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1665177163W00000X
COAPN.1000575-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse