MEDICARE: GEORDAN STOLZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1083505267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORDAN STOLZ

Provider Business Mailing Address
First Line	:	27746 IRIS RD
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81006-9709
Country	:	US
Telephone Number	:	719-568-7731
Fax Number	:

Provider Business Practice Location Address
First Line	:	6311 VILLAGE LN
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-8349
Country	:	US
Telephone Number	:	719-568-7731
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2025
Last Update Date	:	07/14/2025

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Directions to “ GEORDAN STOLZ ” Practice Location

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