Provider Demographics
NPI:1437496023
Name:STIRN, PEGGY J (RN, BCB)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:J
Last Name:STIRN
Suffix:
Gender:F
Credentials:RN, BCB
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:J
Other - Last Name:MCNEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1929 WALLENBERG DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1967
Mailing Address - Country:US
Mailing Address - Phone:970-443-0734
Mailing Address - Fax:970-493-1804
Practice Address - Street 1:1929 WALLENBERG DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1967
Practice Address - Country:US
Practice Address - Phone:970-443-0734
Practice Address - Fax:970-493-1804
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO72534163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice