Theresa Amelia Balet, FNP

Individual provider Active NPI Family Nurse Practitioner · Montrose, CO

NPI 1831270438 · NPPES record last updated Apr 11, 2016

Key facts

NPI
1831270438
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
66777 (CO)
Practice address
1845 S Townsend Ave
Montrose, CO 81401-5448
Phone
(970) 252-5015
Fax
(970) 964-2499
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
66777COMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 66777 CO Yes

Addresses

Primary practice location

1845 S Townsend Ave
Montrose, CO 81401-5448

Mailing address

1845 S Townsend Ave
Montrose, CO 81401-5448
Phone (970) 252-5015

Other identifiers

IdentifierTypeStateIssuer
02130751MedicaidCO
M0090407OtherELECTRONIC PROVIDER NUMBE
363L00000XOtherSPECIALTY CODE

Other providers in Montrose, CO

All providers in Montrose, CO · Family Nurse Practitioner in Colorado

Sources for this page

Verify at the official NPI Registry.