Individual
MRS. THERESA AMELIA BALET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1845 S TOWNSEND AVE, MONTROSE, CO 81401-5448
(970) 252-5015
(970) 964-2499
Mailing address
1845 S TOWNSEND AVE, MONTROSE, CO 81401-5448
(970) 252-5015
(970) 964-2499
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
66777
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02130751
—
CO
01
—
363L00000X
SPECIALTY CODE
—
01
—
M0090407
ELECTRONIC PROVIDER NUMBE
—
Enumeration date
10/18/2006
Last updated
04/11/2016
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