Basic Information
| Provider Information | |||||||||
| NPI: | 1164446324 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRIBBS | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | |||||||||
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| Credential: | DO | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WYATT | ||||||||
| OtherFirstName: | HEATHER | ||||||||
| OtherMiddleName: | D | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8080 PARK MEADOWS DR. | ||||||||
| Address2: | |||||||||
| City: | LONE TREET | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801242558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033468828 | ||||||||
| FaxNumber: | 3033460407 | ||||||||
| Practice Location | |||||||||
| Address1: | 8080 PARK MEADOWS DR. | ||||||||
| Address2: | |||||||||
| City: | LONE TREE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801242558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9182589111 | ||||||||
| FaxNumber: | 9182519339 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 10/14/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0052172 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.