Provider Demographics
NPI:1043661127
Name:STOUGHTON, JESSICA (RN, MS, CPNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:STOUGHTON
Suffix:
Gender:F
Credentials:RN, MS, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:720-848-0000
Mailing Address - Fax:
Practice Address - Street 1:1775 AURORA CT
Practice Address - Street 2:MAIL STOP A140
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2536
Practice Address - Country:US
Practice Address - Phone:303-724-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0992588-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics