Individual
STACY L MELVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
10107 RIDGEGATE PKWY STE 200, LONE TREE, CO 80124-5641
(303) 925-0700
(303) 329-2599
Mailing address
10107 RIDGEGATE PKWY STE 200, LONE TREE, CO 80124-5641
(303) 925-0700
(303) 329-2599
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
C-APN.0001408-C-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283727001
—
TX
Enumeration date
07/13/2011
Last updated
04/01/2019
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