Healthcare Provider Details

I. General information

NPI: 1972493609
Provider Name (Legal Business Name): AARON STUBER RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2025
Last Update Date: 07/04/2025
Certification Date: 07/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4747 ARAPAHOE AVE
BOULDER CO
80303-1131
US

IV. Provider business mailing address

3680 PAONIA ST
BOULDER CO
80301-3754
US

V. Phone/Fax

Practice location:
  • Phone: 303-415-7000
  • Fax:
Mailing address:
  • Phone: 503-729-6580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1623157
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: