Provider Demographics
NPI:1962721993
Name:STALKER, ERIN MICHELE (FNP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MICHELE
Last Name:STALKER
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 1:1107 S LEMAY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3959
Mailing Address - Country:US
Mailing Address - Phone:970-484-1757
Mailing Address - Fax:970-484-9924
Practice Address - Street 1:1107 S LEMAY AVE STE 200
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524
Practice Address - Country:US
Practice Address - Phone:970-484-1757
Practice Address - Fax:970-484-9924
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO162065163W00000X
CO10348363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO83181253Medicaid
COCOA102367Medicare PIN