STACY C DERRERA

ELIZABETH, CO
NPI1144867243
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: CO  APN.0995141-NP)
Enumeration Date2019-12-08
Last Update Date2020-01-09
Business Address
STACY C DERRERA NP
309 RUSHMORE ST
ELIZABETH, CO 80107-7928
Phone number: 970-619-9084
Mailing Address
STACY C DERRERA NP
10900 W 44TH AVE UNIT 200
WHEAT RIDGE, CO 80033-2742
Phone number: 303-993-1330
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