Healthcare Provider Details

I. General information

NPI: 1376467241
Provider Name (Legal Business Name): TERESA CHARLOTTE CONNOLLY RN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13120 E 19TH AVE
AURORA CO
80045-2567
US

IV. Provider business mailing address

13120 E 19TH AVE
AURORA CO
80045-2567
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-2219
  • Fax:
Mailing address:
  • Phone: 303-724-2219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License Number1624494
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: