Provider Demographics
NPI:1487170502
Name:STELLMON, SUNSHINE CELESTINA (FNP)
Entity type:Individual
Prefix:
First Name:SUNSHINE
Middle Name:CELESTINA
Last Name:STELLMON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 LODGEPOLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3136
Mailing Address - Country:US
Mailing Address - Phone:505-363-1779
Mailing Address - Fax:
Practice Address - Street 1:1100 HAXTON DR UNIT 100
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-6213
Practice Address - Country:US
Practice Address - Phone:970-223-1211
Practice Address - Fax:970-444-2220
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-21
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-02757207Q00000X
COAPN.0995607-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty