Basic Information
| Provider Information | |||||||||
| NPI: | 1487037537 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEFANI | ||||||||
| FirstName: | KATIE | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 17312 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802170312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033884076 | ||||||||
| FaxNumber: | 3033200439 | ||||||||
| Practice Location | |||||||||
| Address1: | 4500 E 9TH AVE STE 330 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802203930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033884076 | ||||||||
| FaxNumber: | 3033200439 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2015 | ||||||||
| LastUpdateDate: | 05/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | C-RXN.0000688-C-NP | CO | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.