Provider Demographics
NPI:1053888230
Name:SCHWERDTFEGER, HEIDI KIM (BSN)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:KIM
Last Name:SCHWERDTFEGER
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19570 BRIGHT WING TRL
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-1392
Mailing Address - Country:US
Mailing Address - Phone:172-030-8879
Mailing Address - Fax:
Practice Address - Street 1:19570 BRIGHT WING TRL
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80908-1392
Practice Address - Country:US
Practice Address - Phone:172-030-8879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0165415163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse