MEDICARE: KIRK STONER C-APN, PMHNP-BC

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	163W00000X	Registered Nurse	1689067	CO
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN.0998620-NP	CO

General Provider Information

NPI Number	:	1437844909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRK STONER C-APN, PMHNP-BC

Provider Business Mailing Address
First Line	:	7209 GRAND PRAIRIE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-8799
Country	:	US
Telephone Number	:	308-237-9202
Fax Number	:

Provider Business Practice Location Address
First Line	:	630 SOUTHPOINTE CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-3896
Country	:	US
Telephone Number	:	719-249-8638
Fax Number	:	719-249-8592

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

Provider Enumeration Date	:	04/10/2023
Last Update Date	:	03/26/2024

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