Individual
COLLEEN TETZLAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
222 AUBURN ST, STE 103, PORTLAND, ME 04103-6005
(207) 699-3838
(855) 216-3778
Mailing address
PO BOX 1638, ALBANY, NY 12201-1638
(207) 777-4111
(207) 783-6660
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP81384
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30344710
—
NH
05
—
432379199
—
ME
Enumeration date
09/15/2006
Last updated
03/25/2019
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