MEDICARE: KARA STUTZMAN

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	2472E0500X	EEG Technician

General Provider Information

NPI Number	:	1235906520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARA STUTZMAN

Provider Business Mailing Address
First Line	:	133 DEER PATH AVE
Second Line	:
City	:	MANITOU SPRINGS
State	:	CO
Zip	:	80829-2163
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2149 N ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-1507
Country	:	US
Telephone Number	:	719-661-6422
Fax Number	:

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

Provider Enumeration Date	:	12/06/2023
Last Update Date	:	12/07/2023

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Directions to “ KARA STUTZMAN ” Practice Location

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