Individual
TERESA T ETTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10103 RIDGEGATE PKWY, SUITE 200, LONE TREE, CO 80124-5520
(303) 788-6657
(303) 788-8837
Mailing address
4900 S MONACO ST, SUITE 210, DENVER, CO 80237-3486
(303) 788-6657
(303) 788-8837
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
40631
CO
207V00000X
Obstetrics & Gynecology Physician
Primary
40631
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160059141
RAILROAD MEDICARE
CO
05
—
76185273
—
CO
Enumeration date
01/23/2007
Last updated
02/01/2022
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