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General NPI Number Information
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NPI Number | 1780964049
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Entity Type | Individual
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Provider Name | STACEY ERIN MCNULTY
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Gender | Female
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Dates
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Enumeration Date | 08/18/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 401 W HAMPDEN PL STE 240
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City | ENGLEWOOD
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State | CO
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Zip | 80110-2471
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Country | US
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Telephone | 303-788-7880
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Fax | 303-788-7883
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Provider Business Mailing Address
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Address Line | 401 W HAMPDEN PL STE 240
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City | ENGLEWOOD
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State | CO
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Zip | 80110-2471
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Country | US
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Telephone | 303-788-7880
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Fax | 303-788-7883
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 1601000595
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 738
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License Number State | CO
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