Doctor Name: | TERESA T ETTEN |
NPI Number: | 1265587224 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 40631 |
Business Practice Address: | 10103 Ridgegate Parkway Suite 200 Lone Tree, CO - 801245525 |
Business Phone Number: | 3037886657 |
Business Fax Number: | 3037888837 |
Mailing Address: | 4900 S Monaco St, Suite 210 DENVER |
State: | CO |
Postal Code: | 802373486 |
Phone Number: | 3037886657 |
Fax Number: | 3037888837 |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 10/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 40631 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |