Provider Demographics
NPI:1790245736
Name:CALABRESE, THERESE JEAN (APRN)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:JEAN
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4516 E HIGHWAY 20 # 105
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-9755
Mailing Address - Country:US
Mailing Address - Phone:850-543-7435
Mailing Address - Fax:
Practice Address - Street 1:20000 S COLORADO BLVD
Practice Address - Street 2:TOWER ONE, SUITE 2000
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4493
Practice Address - Country:US
Practice Address - Phone:303-500-6585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001907363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health