Healthcare Provider Details

I. General information

NPI: 1871200451
Provider Name (Legal Business Name): CHALANNE STOCKMAN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHALANNE RAMPA

II. Dates (important events)

Enumeration Date: 11/02/2022
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3676 PARKER BLVD STE 260
PUEBLO CO
81008-2282
US

IV. Provider business mailing address

3001 HIGH ST
PUEBLO CO
81008-1245
US

V. Phone/Fax

Practice location:
  • Phone: 719-553-2201
  • Fax:
Mailing address:
  • Phone: 719-947-5821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0998164-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: