COLLEEN TETZLAFF FNP NPI 1710083233

NPI Information

NPI: 1710083233
Provider Name: COLLEEN TETZLAFF, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
222 AUBURN ST
STE 103
PORTLAND, ME
ZIP 04103
Phone: (207) 699-3838
Get Directions

Colleen Tetzlaff, FNP is a family nurse practitioner in Portland, ME with 27 years of experience. Colleen Tetzlaff, FNP NPI is 1710083233. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

222 AUBURN ST
STE 103
PORTLAND, ME
ZIP 04103-005
Phone: (207) 699-3838
Fax: (855) 216-3778

The NPI 1710083233 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/15/2006 and was last updated on 3/25/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	CNP81384	MAINE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	30344710	MEDICAID	NEW HAMPSHIRE
2	432379199	MEDICAID	MAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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