Healthcare Provider Details

I. General information

NPI: 1699247155
Provider Name (Legal Business Name): THERESA NICOLE CRETEN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2018
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1683 MAIN ST
WINDSOR CO
80550-7921
US

IV. Provider business mailing address

1683 MAIN ST
WINDSOR CO
80550-7921
US

V. Phone/Fax

Practice location:
  • Phone: 970-449-0951
  • Fax: 970-823-9004
Mailing address:
  • Phone: 970-449-0951
  • Fax: 970-823-9004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: