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Individual

TERESA TANABE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5996 E 64TH AVE, COMMERCE CITY, CO 80022-3317
(720) 463-6758
Mailing address
PO BOX 746081, ATLANTA, GA 30374-6081
(312) 733-9730
(303) 996-1600

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
991480
CO
363LG0600X
Gerontology Nurse Practitioner
Primary
APN.0991480-NP
CO
363LP2300X
Primary Care Nurse Practitioner
95000952
CA
363LP2300X
Primary Care Nurse Practitioner
APN.0991480-NP
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07786751
CO
Enumeration date
10/05/2014
Last updated
07/21/2023
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