Provider Demographics
NPI:1316287220
Name:YORK, STASI (MT, CD, CBE)
Entity type:Individual
Prefix:
First Name:STASI
Middle Name:
Last Name:YORK
Suffix:
Gender:F
Credentials:MT, CD, CBE
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:
Other - Last Name:YORK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MT, CD, CBE
Mailing Address - Street 1:771 N CEDAR BROOK RD
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-0441
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:771 N CEDAR BROOK RD
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-0441
Practice Address - Country:US
Practice Address - Phone:303-807-6504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator