Provider Demographics
NPI:1235339292
Name:JHA, STACY R (LPN)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:R
Last Name:JHA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 DETROIT ST
Mailing Address - Street 2:101
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4371
Mailing Address - Country:US
Mailing Address - Phone:303-398-6142
Mailing Address - Fax:
Practice Address - Street 1:335 DETROIT ST
Practice Address - Street 2:101
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4371
Practice Address - Country:US
Practice Address - Phone:720-272-3726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38251164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse