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General NPI Number Information
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NPI Number | 1295340461
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Entity Type | Individual
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Provider Name | MELISSA STIBBENS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 1400 E BOULDER ST STE 500
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-5533
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Country | US
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Telephone | 719-364-6487
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 267
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City | FLORISSANT
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State | CO
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Zip | 80816-0267
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Country | US
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Telephone | 303-241-0263
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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 | 0163322
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.0995917-NP
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License Number State | CO
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