Provider Demographics
NPI:1407176985
Name:STUENZI, JESSICA (APRN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:STUENZI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9878 W BELLEVIEW AVE STE 2242
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80123-2101
Mailing Address - Country:US
Mailing Address - Phone:720-343-3752
Mailing Address - Fax:720-216-2276
Practice Address - Street 1:9878 W BELLEVIEW AVE STE 2242
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80123-2101
Practice Address - Country:US
Practice Address - Phone:720-335-5742
Practice Address - Fax:720-216-2276
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO192501163W00000X
COAPN.0994557-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000175638Medicaid