Provider Demographics
NPI:1659415446
Name:STANTON, NANCY J (NP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:STANTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14260 SHADOW WOOD CT
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80603-8340
Mailing Address - Country:US
Mailing Address - Phone:303-929-9406
Mailing Address - Fax:
Practice Address - Street 1:6041 S SYRACUSE WAY STE 220
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-4716
Practice Address - Country:US
Practice Address - Phone:720-482-1988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101116363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO19737521Medicaid
CO1M7362OtherMEDICARE PTAN
COP20539Medicare UPIN
COCK11033Medicare PIN
CO19737521Medicaid