Gruka, Stacey Lane
Gruka, Stacey Lane is an individual health care provider with primary practice located at 1925 Mountain View Ave , Longmont CO 80501-3128. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Gruka, Stacey Lane can be contacted via phone (720) 494-3130.Contact Information
Primary practice address
1925 Mountain View Ave
Longmont CO 80501-3128
Phone: (720) 494-3130
Fax: (720) 494-3176
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | C-APN.0003341-C-CNM | Colorado |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | APRN9246057 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | ARNP9246057 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | C-APN.0003341-C-CNM | California |
Profile Details
| NPI number | 1982879011 |
|---|---|
| LBN Legal business name | Gruka, Stacey Lane |
| Credentials | DNP, ARNP, CNM, MSN |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 29th, 2008 |
| Last updated | Jan 27th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982879011 | NPPES |
| Colorado | MEDICAID | 9000200515 | |
| Colorado | MEDICAID | 000102200 |
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