Provider Demographics
NPI:1447642608
Name:ANN, STEPHANIE (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ANN
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12616 W VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2609
Mailing Address - Country:US
Mailing Address - Phone:720-515-8700
Mailing Address - Fax:
Practice Address - Street 1:6279 W 38TH AVE STE 4
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-5068
Practice Address - Country:US
Practice Address - Phone:720-515-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-25
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO2077171100000X
CO2077171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist