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General NPI Number Information
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NPI Number | 1114691102
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Entity Type | Individual
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Provider Name | STEPHANIE MARIE PETERSEN DUPUIS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 6550 YANK WAY
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City | ARVADA
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State | CO
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Zip | 80004-2200
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Country | US
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Telephone | 303-424-6550
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Fax |
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Provider Business Mailing Address
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Address Line | 295 E SPEER BLVD APT 400
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City | DENVER
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State | CO
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Zip | 80203-3580
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Country | US
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Telephone | 917-232-9853
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0996664-NP
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License Number State | CO
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