Healthcare Provider Details

I. General information

NPI: 1437496023
Provider Name (Legal Business Name): PEGGY J. STIRN RN, BCB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PEGGY J. MCNEIL RN

II. Dates (important events)

Enumeration Date: 01/15/2013
Last Update Date: 01/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 WALLENBERG DR
FORT COLLINS CO
80526-1967
US

IV. Provider business mailing address

1929 WALLENBERG DR
FORT COLLINS CO
80526-1967
US

V. Phone/Fax

Practice location:
  • Phone: 970-443-0734
  • Fax: 970-493-1804
Mailing address:
  • Phone: 970-443-0734
  • Fax: 970-493-1804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number72534
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: