Theresa Fedak, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

86240 Issued in CO

Practice address

3145 20TH St
Boulder, CO 80304-2700

Phone

(303) 447-8189

NPI assigned

Jul 26, 2005

Last updated

Jan 6, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1205836848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 20TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803042700",
            "telephone_number": "303-447-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 20TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803042700",
            "telephone_number": "303-447-8189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDAK",
        "first_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "86240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Faucheux, LPC
• Joseph Alexander John Faulkner, LPCC
• Steven G Faust, PT
• Jessica Fawcett, CD
• Danielle Feaster
• Heidi Jaye Fedor, LPC, LMFT
• Yevgeniy Fedorov
• Feel Play Grow
• Emily Rose Feero, DC
• Feet Forward - Peer Services and Outreach (Boulder Feet Forward)

• Family Nurse Practitioner in Boulder, CO
• Providers in Boulder, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.