Individual
MARY TERESA BAGSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2635 N 7TH ST, GRAND JUNCTION, CO 81501-8209
(970) 244-1977
(970) 244-2898
Mailing address
DEPT 0861, DENVER, CO 80256-0001
(866) 898-7136
(616) 975-9824
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
73645
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67126855
—
CO
Enumeration date
07/08/2008
Last updated
10/07/2008
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