Individual
STEPHANIE TRACIE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1720 JET STREAM DR STE 200, COLORADO SPRINGS, CO 80921-3938
(719) 635-3764
(719) 635-7593
Mailing address
11528 LOUVRE PT, PEYTON, CO 80831-8225
(304) 860-2012
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN.0999562-NP
CO
Other
Enumeration date
02/16/2024
Last updated
10/15/2025
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