Individual
LISA NICOLE HEINECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, LMT
Contact information
Practice address
2524 W COLORADO AVE STE 205, COLORADO SPRINGS, CO 80904-6016
(719) 257-3177
Mailing address
2117 W KIOWA ST, COLORADO SPRINGS, CO 80904-3445
(719) 257-3177
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1626334
CO
225700000X
Massage Therapist
Primary
MT.0022615
CO
Other
Enumeration date
02/03/2023
Last updated
11/09/2024
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