Provider Demographics
NPI:1265826408
Name:GILLEY, STEPHANIE PRITCHARD (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:PRITCHARD
Last Name:GILLEY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:PRITCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13123 E 16TH AVE # 270
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7106
Mailing Address - Country:US
Mailing Address - Phone:720-777-6638
Mailing Address - Fax:
Practice Address - Street 1:13123 E 16TH AVE # 270
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-2691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO60140208000000X
CODR.00601402080P1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P1004XAllopathic & Osteopathic PhysiciansPediatricsPhysician Nutrition Specialist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics