Individual provider Active NPI

Stephanie Marie Liedholm-Heining

  • Registered Nurse
  • Conifer, CO
National Provider Identifier
1033028675
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.0127536 Issued in CO
Practice address
11513 Hannah Dr
Conifer, CO 80433-7531
Phone
(612) 247-2142
NPI assigned
Sep 1, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 126562-4 MN
Registered Nurse 163W00000X RN.0127536 CO Primary

Addresses

Primary practice location

11513 Hannah Dr
Conifer, CO 80433-7531

Mailing address

11513 Hannah Dr
Conifer, CO 80433-7531
Phone (612) 247-2142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1788220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1033028675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11513 HANNAH DR",
            "city": "CONIFER",
            "state": "CO",
            "postal_code": "804337531",
            "telephone_number": "612-247-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11513 HANNAH DR",
            "city": "CONIFER",
            "state": "CO",
            "postal_code": "804337531",
            "telephone_number": "612-247-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEDHOLM-HEINING",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-01",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "126562-4",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0127536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conifer, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.