Individual
STACEY BRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7999 S FULTONDALE WAY, AURORA, CO 80016-4442
(303) 512-3690
Mailing address
7999 S FULTONDALE WAY, AURORA, CO 80016-4442
(303) 512-3690
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0996402
CO
363LG0600X
Gerontology Nurse Practitioner
0996402
CO
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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