Healthcare Provider Details

I. General information

NPI: 1023976024
Provider Name (Legal Business Name): KATLYN STAHL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2026
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9191 GRANT ST
THORNTON CO
80229-4361
US

IV. Provider business mailing address

120 EDGEVIEW DR APT 6318
BROOMFIELD CO
80021-8099
US

V. Phone/Fax

Practice location:
  • Phone: 303-451-7800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1001431
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: