Provider Demographics
NPI:1174239396
Name:COLON, HEATHER (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:COLON
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 1:7230 GRANDVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6549
Mailing Address - Country:US
Mailing Address - Phone:828-999-2382
Mailing Address - Fax:
Practice Address - Street 1:7230 GRANDVIEW BLVD
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6549
Practice Address - Country:US
Practice Address - Phone:828-999-2382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11023916363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily