Provider Demographics
NPI:1205209731
Name:KAGAN, STEPHANIE ELIZABETH-EATON (NP)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ELIZABETH-EATON
Last Name:KAGAN
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 1:271 W COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-1901
Mailing Address - Country:US
Mailing Address - Phone:303-794-0045
Mailing Address - Fax:
Practice Address - Street 1:271 W COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-1901
Practice Address - Country:US
Practice Address - Phone:303-794-0045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPP.0995840-NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health