Healthcare Provider Details

I. General information

NPI: 1346400413
Provider Name (Legal Business Name): STEPPING STONES PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 07/26/2024
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 LAKE AVENUE
PUEBLO CO
81004
US

IV. Provider business mailing address

1910 LAKE AVENUE
PUEBLO CO
81004
US

V. Phone/Fax

Practice location:
  • Phone: 719-583-2330
  • Fax: 719-583-2670
Mailing address:
  • Phone: 719-583-2330
  • Fax: 719-583-5670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number37792
License Number StateCO

VIII. Authorized Official

Name: ELIZABETH ANN EHRHARDT
Title or Position: OWNER
Credential: MD
Phone: 719-583-2330