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Individual

MARY ELIZABETH STULTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
198 UNION BLVD, SUITE 150, LAKEWOOD, CO 80228-2259
(303) 892-6033
(303) 573-6929
Mailing address
198 UNION BLVD, SUITE 150, LAKEWOOD, CO 80228-2259
(303) 892-6033
(303) 573-6929

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
3345
CO
363AM0700X
Medical Physician Assistant
Primary
C000333
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
92878563
CO
Enumeration date
10/20/2006
Last updated
11/30/2020
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