1932195054 NPI number — MR. TERENCE JOHN CALDWELL FNP-C, MSN, MPH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932195054 NPI number — MR. TERENCE JOHN CALDWELL FNP-C, MSN, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CALDWELL
Provider First Name:
TERENCE
Provider Middle Name:
JOHN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
FNP-C, MSN, MPH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932195054
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2510 W BIJOU ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80904-2503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-434-1757
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
825 E PIKES PEAK AVE
Provider Second Line Business Practice Location Address:
SET FAMILY MEDICAL CLINIC
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80903-3624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-776-8850
Provider Business Practice Location Address Fax Number:
719-776-8854
Provider Enumeration Date:
09/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  APN.990458-NP , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: APN.990458-NP . This is a "ADVANCE PRACTICE REGISTRY" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 203539 . This is a "COLORADO MULTI-STATE RN" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: AP0802 . This is a "APN/RXN" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: F1298032 . This is a "AANP FAMILY NURSE PRACTITIONER CERTIFICATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: RXN.100471-NP . This is a "PRESCRIPTIVE AUTHORITY" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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