Basic Information
| Provider Information | |||||||||
| NPI: | 1093796567 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TURGEON | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | LEA | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 660 GOLDEN RIDGE RD STE 250 | ||||||||
| Address2: | |||||||||
| City: | GOLDEN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804019541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033321223 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2725 S 144TH ST STE 212 | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681445253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4026370800 | ||||||||
| FaxNumber: | 4026370808 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2005 | ||||||||
| LastUpdateDate: | 03/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 073544 | IA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | PA.0004378 | CO | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 1337 | NE | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 1500344 | KS | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.