Provider Demographics
NPI:1114284346
Name:EKLUND, TESS
Entity Type:Individual
Prefix:MS
First Name:TESS
Middle Name:
Last Name:EKLUND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10255 DOVER ST APT 432
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3986
Mailing Address - Country:US
Mailing Address - Phone:970-376-1729
Mailing Address - Fax:
Practice Address - Street 1:3000 CENTER GREEN DR STE 150
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2364
Practice Address - Country:US
Practice Address - Phone:303-449-8807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1530246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1530OtherACTIVE SURGICAL ASSISTANT