Individual
STEPHANIE RENE EARHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
550 W HWY 50, SALIDA, CO 81201-2238
(719) 530-2022
(719) 539-2065
Mailing address
550 W HWY 50, SALIDA, CO 81201-2238
(719) 530-2022
(719) 539-2065
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44295
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44295
STATE LICENSE
CO
05
—
55325785
—
CO
Enumeration date
07/09/2006
Last updated
03/05/2021
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