Provider Demographics
NPI:1679977284
Name:RAHIM, HEATHER HOUSTON (RN, A-NP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:HOUSTON
Last Name:RAHIM
Suffix:
Gender:F
Credentials:RN, A-NP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LYNN
Other - Last Name:HOUSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2225 MEADE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211
Mailing Address - Country:US
Mailing Address - Phone:317-440-5896
Mailing Address - Fax:
Practice Address - Street 1:3550 LUTHERAN PKWY BLDG 10
Practice Address - Street 2:STE 200
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6017
Practice Address - Country:US
Practice Address - Phone:720-536-2100
Practice Address - Fax:720-536-2090
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN0991279-NP363LA2200X
CO991279207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO389908ZLKROtherMEDICARE PTAN