Healthcare Provider Details

I. General information

NPI: 1568528313
Provider Name (Legal Business Name): TERRI ANN PASCHETAG APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 W DRAKE RD STE 101
FORT COLLINS CO
80526
US

IV. Provider business mailing address

5920 MCINTYRE ST
GOLDEN CO
80403-7445
US

V. Phone/Fax

Practice location:
  • Phone: 970-494-6449
  • Fax: 970-482-0198
Mailing address:
  • Phone: 720-434-4876
  • Fax: 303-225-4246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number230800
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number230800
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP102255
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.0992452-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: