Individual
MS. STACY BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1263 LAKE PLAZA DR STE 120, COLORADO SPRINGS, CO 80906-3510
(719) 776-3330
(719) 776-3349
Mailing address
1263 LAKE PLAZA DR STE 120, COLORADO SPRINGS, CO 80906-3510
(719) 776-3330
(719) 776-3349
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
008199
GA
363A00000X
Physician Assistant
PA.0006643
CO
363AM0700X
Medical Physician Assistant
Primary
PA.0006643
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000190983
—
CO
Enumeration date
11/23/2016
Last updated
03/08/2023
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