Healthcare Provider Details

I. General information

NPI: 1932432382
Provider Name (Legal Business Name): MRS. STACEY ELIZABETH SIMPSON-FLEMING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 09/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 GRANT ST
DENVER CO
80203-2907
US

IV. Provider business mailing address

980 GRANT ST
DENVER CO
80203-2907
US

V. Phone/Fax

Practice location:
  • Phone: 303-832-3668
  • Fax: 303-861-1403
Mailing address:
  • Phone: 303-832-3668
  • Fax: 303-861-1403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMT-6090
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: