Provider Demographics
NPI:1366288243
Name:HUIZENGA, TESSA LYNN (RN)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:LYNN
Last Name:HUIZENGA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16920 CARLSON DR APT 335
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-6809
Mailing Address - Country:US
Mailing Address - Phone:307-216-0274
Mailing Address - Fax:
Practice Address - Street 1:13120 E 19TH AVE # 80045
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2567
Practice Address - Country:US
Practice Address - Phone:303-724-2915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1642366163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse