Individual
MS. THERESA FEDAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3145 20TH ST, BOULDER, CO 80304-2700
(303) 447-8189
Mailing address
3145 20TH ST, BOULDER, CO 80304-2700
(303) 447-8189
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
86240
CO
Other
Enumeration date
07/26/2005
Last updated
01/06/2016
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