Individual
MS. KELLY ANN STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7875 MANSTON DR, COLORADO SPRINGS, CO 80920-8051
(719) 635-7026
Mailing address
7875 MANSTON DR, COLORADO SPRINGS, CO 80920-8051
(719) 635-7026
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
110204
CO
Other
Enumeration date
08/30/2009
Last updated
08/30/2009
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