Provider Demographics
NPI:1710956677
Name:QUIRK, STEFANIE P (ACNP)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:P
Last Name:QUIRK
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 N NEVADA AVE
Mailing Address - Street 2:STE 4007
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6819
Mailing Address - Country:US
Mailing Address - Phone:719-776-8500
Mailing Address - Fax:719-634-1448
Practice Address - Street 1:2222 N NEVADA AVE
Practice Address - Street 2:STE 4007
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6819
Practice Address - Country:US
Practice Address - Phone:719-776-8500
Practice Address - Fax:719-634-1448
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX617747363LA2100X
CO5639363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157643101Medicaid
TXP54456Medicare UPIN
TX87N307Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER