Organization
PREMIER OB-GYN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY HENNESY (MD)
(303) 854-3681
Entity
Organization
Contact information
Practice address
9195 GRANT ST, SUITE 400, THORNTON, CO 80229-4385
(303) 854-3681
(303) 426-4154
Mailing address
9195 GRANT ST, SUITE 400, THORNTON, CO 80229-4385
(303) 854-3681
(303) 426-4154
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
40865
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72507560
—
CO
Enumeration date
03/16/2009
Last updated
01/29/2010
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