Healthcare Provider Details

I. General information

NPI: 1992559439
Provider Name (Legal Business Name): TESS BOTTORFF DNP, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2024
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 N HIGH ST
DENVER CO
80205-5555
US

IV. Provider business mailing address

4700 E KENTUCKY AVE APT 217
DENVER CO
80246-2012
US

V. Phone/Fax

Practice location:
  • Phone: 720-754-1000
  • Fax:
Mailing address:
  • Phone: 773-999-0586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number304512
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAPN.1000066-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: