Provider Demographics
NPI:1295054690
Name:CALMES-NORGAARD, TARA S (DNP)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:S
Last Name:CALMES-NORGAARD
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:CALMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP
Mailing Address - Street 1:2362 E PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1357
Mailing Address - Country:US
Mailing Address - Phone:970-495-0999
Mailing Address - Fax:970-495-1016
Practice Address - Street 1:2362 E PROSPECT RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1357
Practice Address - Country:US
Practice Address - Phone:970-495-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI150712363L00000X
CO100061363LA2200X
MNR217224-0363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA107168OtherPTAN