Provider Demographics
NPI:1053124818
Name:TREGARTHEN, DORAN RICHARD (FNP)
Entity type:Individual
Prefix:
First Name:DORAN
Middle Name:RICHARD
Last Name:TREGARTHEN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 1940 RD
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-8311
Mailing Address - Country:US
Mailing Address - Phone:970-250-8975
Mailing Address - Fax:
Practice Address - Street 1:230 HOTCHKISS AVE
Practice Address - Street 2:
Practice Address - City:HOTCHKISS
Practice Address - State:CO
Practice Address - Zip Code:81419-7608
Practice Address - Country:US
Practice Address - Phone:970-872-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.1000487-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAPN.1000487-NPOtherCOLORADO DEPARTMENT OF REGULATORY AGENCIES