Stacey Brake, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

0996402 Issued in CO

Practice address

7999 S Fultondale Way
Aurora, CO 80016-4442

Phone

(303) 512-3690

NPI assigned

Jun 9, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1336716299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7999 S FULTONDALE WAY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800164442",
            "telephone_number": "303-512-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7999 S FULTONDALE WAY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800164442",
            "telephone_number": "303-512-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAKE",
        "first_name": "STACEY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "0996402",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "0996402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Aurora",
            "affiliation": "N",
            "address_1": "7999 S Fultondale Way",
            "city": "Aurora",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800164442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lucy Braham, LPC
• Gina Braidman, PA
• Jason Brainard, MD
• Brainwave Neuro Rehab Services LLC
• Angela Jean Braithwood, RN
• Elizabeth L Brallier
• Belinda Sanchez Brambila, RN
• Gregory Patrick Brames, MD
• Jonathan David Bramm, AA
• Christopher Brammer, DO

• Adult Health Nurse Practitioner in Aurora, CO
• Providers in Aurora, CO by specialty
• Adult Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.