Basic Information
| Provider Information | |||||||||
| NPI: | 1710170717 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OWENS | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4500 E 9TH AVE STE 470 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802203923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033208499 | ||||||||
| FaxNumber: | 3033208620 | ||||||||
| Practice Location | |||||||||
| Address1: | 4650 W 38TH AVE STE 215 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802122161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033208499 | ||||||||
| FaxNumber: | 3033208620 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2007 | ||||||||
| LastUpdateDate: | 01/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD429655 | PA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 46540 | CO | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 88682838 | 05 | CO | MEDICAID |