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General NPI Number Information
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NPI Number | 1205821824
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Entity Type | Individual
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Provider Name | STACEY LORRAINE HENNESY MD
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Gender | Female
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 11/26/2018
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Provider Practice Location Address
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Address Line | 14300 ORCHARD PKWY
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City | WESTMINSTER
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State | CO
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Zip | 80023-9206
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Country | US
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Telephone | 303-426-2580
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Fax | 303-426-2590
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Provider Business Mailing Address
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Address Line | PO BOX 911057
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City | DENVER
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State | CO
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Zip | 80291-1057
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Country | US
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Telephone | 800-953-0104
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Fax | 303-765-6640
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35332
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License Number State | CO
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