Basic Information
| Provider Information | |||||||||
| NPI: | 1508087073 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINDER | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 280 | ||||||||
| Address2: | |||||||||
| City: | NORWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 814230280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703274233 | ||||||||
| FaxNumber: | 9703274228 | ||||||||
| Practice Location | |||||||||
| Address1: | 1350 S. ASPEN STREET | ||||||||
| Address2: | |||||||||
| City: | NORWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703274233 | ||||||||
| FaxNumber: | 9703274228 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 05/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD 60021583 | WA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 52317 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 66838045 | 05 | CO | MEDICAID |