Healthcare Provider Details

I. General information

NPI: 1790169431
Provider Name (Legal Business Name): BARBARA J STANLEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2015
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 STODDARD DR
FORT COLLINS CO
80526
US

IV. Provider business mailing address

7411 N NEVADA ST
SPOKANE WA
99208-5518
US

V. Phone/Fax

Practice location:
  • Phone: 970-231-0223
  • Fax:
Mailing address:
  • Phone: 970-231-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberAP61591903
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPN.0991472-NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP61591903
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: