Provider Demographics
NPI:1750383394
Name:BALES, STEPHEN (RN NP)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:BALES
Suffix:
Gender:M
Credentials:RN NP
Other - Prefix:
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Mailing Address - Street 1:850 E HARVARD AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5076
Mailing Address - Country:US
Mailing Address - Phone:303-825-8822
Mailing Address - Fax:303-825-4022
Practice Address - Street 1:850 E HARVARD AVE STE 305
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5076
Practice Address - Country:US
Practice Address - Phone:303-825-8822
Practice Address - Fax:303-825-4022
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103336363LA2200X
COAPN.2805-NP208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC809189Medicare PIN
P64475Medicare UPIN