Provider Demographics
NPI:1992559439
Name:BOTTORFF, TESS (DNP, NNP-BC)
Entity type:Individual
Prefix:
First Name:TESS
Middle Name:
Last Name:BOTTORFF
Suffix:
Gender:F
Credentials:DNP, NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 E KENTUCKY AVE APT 217
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2012
Mailing Address - Country:US
Mailing Address - Phone:773-999-0586
Mailing Address - Fax:
Practice Address - Street 1:2001 N HIGH ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5555
Practice Address - Country:US
Practice Address - Phone:720-754-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ304512163WN0002X
COAPN.1000066-NP363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care