MEDICARE: PEGGY J. STIRN RN, BCB

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	163WG0000X	General Practice Registered Nurse	72534	CO

General Provider Information

NPI Number	:	1437496023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY J. STIRN RN, BCB

Provider Business Mailing Address
First Line	:	1929 WALLENBERG DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-1967
Country	:	US
Telephone Number	:	970-443-0734
Fax Number	:	970-493-1804

Provider Business Practice Location Address
First Line	:	1929 WALLENBERG DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-1967
Country	:	US
Telephone Number	:	970-443-0734
Fax Number	:	970-493-1804

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

Provider Enumeration Date	:	01/15/2013
Last Update Date	:	01/15/2013

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