MEDICARE: STACEY BARNARD FNP

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	363LF0000X	Family Nurse Practitioner	APN.0993236	CO

General Provider Information

NPI Number	:	1982121018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY BARNARD FNP

Provider Business Mailing Address
First Line	:	4819 S VERSAILLES ST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80015-6477
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4819 S VERSAILLES ST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80015-6477
Country	:	US
Telephone Number	:	602-502-7369
Fax Number	:

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

Provider Enumeration Date	:	08/29/2017
Last Update Date	:	08/29/2017

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