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General NPI Number Information
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NPI Number | 1861895807
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Entity Type | Individual
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Provider Name | TERESA TANABE
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Gender | Female
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Dates
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Enumeration Date | 10/05/2014
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 5996 E 64TH AVE
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City | COMMERCE CITY
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State | CO
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Zip | 80022-3317
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Country | US
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Telephone | 720-463-6758
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 746081
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City | ATLANTA
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State | GA
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Zip | 30374-6081
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Country | US
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Telephone | 312-733-9730
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Fax | 303-996-1600
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 991480
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APN.0991480-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 95000952
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APN.0991480-NP
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License Number State | CO
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