Provider Demographics
NPI:1710238530
Name:STOLL, REBECCA N (CRNA)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:N
Last Name:STOLL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:N
Other - Last Name:SCHERMERHORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1236 E ELIZABETH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4000
Mailing Address - Country:US
Mailing Address - Phone:970-224-2985
Mailing Address - Fax:970-472-9381
Practice Address - Street 1:1236 E ELIZABETH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4000
Practice Address - Country:US
Practice Address - Phone:970-224-2985
Practice Address - Fax:970-472-9381
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0990519-CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01207555Medicaid
COP01126149OtherMEDICARE RAILROAD
COP01126149OtherMEDICARE RAILROAD