=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396156162
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANN STAGER RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2014
-----------------------------------------------------
Last Update Date | 08/25/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6162 S. WILLOW DRIVE SUITE 100
-----------------------------------------------------
City | GREEENWOOD VILLAGE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-220-9200
-----------------------------------------------------
Fax | 303-741-4173
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6162 S. WILLOW DRIVE SUITE 100
-----------------------------------------------------
City | GREEENWOOD VILLAGE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-220-9200
-----------------------------------------------------
Fax | 303-741-4173
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 82804
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------