Individual
HEATHER MARIE MISJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1625 MEDICAL CENTER PT, COLORADO SPRINGS, CO 80907-8731
(719) 475-9496
Mailing address
4112 OUTLOOK BLVD, PUEBLO, CO 81008-1667
(719) 475-9496
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2937
CO
363AM0700X
Medical Physician Assistant
MA052759
PA
Other
Enumeration date
12/18/2006
Last updated
03/01/2010
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