NPI 1790931319 · live from the CMS NPI Registry
Stacy Anderson, PNP, CNS
Nurse Practitioner, Pediatrics in Aurora, CO. National Provider Identifier 1790931319, active.
NPI record
| NPI | 1790931319 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 13123 E 16th Ave, Aurora, CO 80045 |
| Practice phone | 720-777-1234 |
| Mailing address | Po Box 110429, Aurora, CO 80042 |
| Enumerated | August 14, 2008 |
| Last updated | February 1, 2013 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Nurse Specialist, Pediatrics | 364SP0200X | 129811 (CO) |
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 4754 (CO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.