Healthcare Provider Details

I. General information

NPI: 1982926184
Provider Name (Legal Business Name): DOROTHY KAY STONER NPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2010
Last Update Date: 11/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 KOKOPELLI BLVD UNIT B
FRUITA CO
81521-8723
US

IV. Provider business mailing address

456 KOKOPELLI BLVD UNIT B
FRUITA CO
81521-8723
US

V. Phone/Fax

Practice location:
  • Phone: 970-639-9505
  • Fax: 970-639-2993
Mailing address:
  • Phone: 970-639-9505
  • Fax: 970-639-2993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number115333
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: