# PREMIER OB-GYN PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003057456
- **Authorized official:** STACEY HENNESY (MD)
- **Authorized official phone:** (303) 854-3681

## Contact information

- **Practice address:** 9195 GRANT ST, SUITE 400, THORNTON, CO 80229-4385
- **Practice address phone:** (303) 854-3681
- **Practice address fax:** (303) 426-4154
- **Mailing address:** 9195 GRANT ST, SUITE 400, THORNTON, CO 80229-4385
- **Mailing address phone:** (303) 854-3681
- **Mailing address fax:** (303) 426-4154

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 40865 | CO | Yes |

## Other

- **Enumeration date:** 03/16/2009
- **Last updated:** 01/29/2010