Provider Demographics
NPI:1134259989
Name:FRESQUES, DONALD J (NP)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:J
Last Name:FRESQUES
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Gender:M
Credentials:NP
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Mailing Address - Street 1:1390 S POTOMAC ST
Mailing Address - Street 2:STE 128
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-6165
Mailing Address - Country:US
Mailing Address - Phone:303-341-0422
Mailing Address - Fax:303-341-1479
Practice Address - Street 1:1390 S POTOMAC ST
Practice Address - Street 2:STE 100
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-6165
Practice Address - Country:US
Practice Address - Phone:303-341-0722
Practice Address - Fax:303-341-0832
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2014-12-09
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Provider Licenses
StateLicense IDTaxonomies
CO92950363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC801687Medicare PIN