Healthcare Provider Details

I. General information

NPI: 1003480302
Provider Name (Legal Business Name): MICHELLE R STELTER APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE R PYEATTE APN

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 01/27/2022
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10103 RIDGEGATE PKWY STE 221
LONE TREE CO
80124-5525
US

IV. Provider business mailing address

10103 RIDGEGATE PKWY STE 221
LONE TREE CO
80124-5525
US

V. Phone/Fax

Practice location:
  • Phone: 303-662-1191
  • Fax: 303-662-1342
Mailing address:
  • Phone: 303-662-1191
  • Fax: 303-662-1343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0996546-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: