Healthcare Provider Details

I. General information

NPI: 1356561161
Provider Name (Legal Business Name): AUDREY ALANA STROCK DNP, AGPCNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4704 HARLAN ST STE 340
DENVER CO
80212-7418
US

IV. Provider business mailing address

PO BOX 12399
DENVER CO
80212-0399
US

V. Phone/Fax

Practice location:
  • Phone: 303-720-1845
  • Fax: 303-479-4958
Mailing address:
  • Phone: 303-720-1845
  • Fax: 303-479-4958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN-172154
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.0991725-NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.991725-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: