Provider Demographics
NPI:1538448816
Name:TESONE, MARTINE PATRICE (DNP, CNM)
Entity type:Individual
Prefix:
First Name:MARTINE
Middle Name:PATRICE
Last Name:TESONE
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Gender:F
Credentials:DNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1107 S LEMAY AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3960
Mailing Address - Country:US
Mailing Address - Phone:970-493-7442
Mailing Address - Fax:970-493-2990
Practice Address - Street 1:2500 ROCKY MOUNTAIN AVE
Practice Address - Street 2:NORTH MOB, SUITE 150
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9004
Practice Address - Country:US
Practice Address - Phone:970-493-7442
Practice Address - Fax:970-493-2990
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2020-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO0013008367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO14877252Medicaid