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Contact Information

THERESA R BACA
2817 TENDER DR
MONTROSE, CO81401-7317
 Phone: 505-506-7333
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

School

363LS0200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for THERESA R BACA · (Female)

NPI Number 1013873967
Status Active
Credentials
Entity Individual
Enumeration date 01/05/2026
Last updated 01/05/2026 - About 5 months ago
Sole proprietor 1 Yes
Identifiers
  • CO License # 1667284
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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