Active NPI
Stacy Lynn Herrera, RN
- Addiction (Substance Use Disorder) Registered Nurse
- Pueblo, CO
National Provider Identifier
1447425517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Registered Nurse
- License
- 130777
- Practice address
- 151 Central Main St
Pueblo, CO 81003-4212 - Phone
- (719) 583-4308
- Fax
- (719) 583-4375
- NPI assigned
- Apr 29, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | 130777 | CO | Primary |
Addresses
Primary practice location
151 Central Main St
Pueblo, CO 81003-4212
Mailing address
4611 Scarlet Sage Dr
Pueblo, CO 81001-1019
Phone (719) 566-8075
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 130777 | CO | MD | Addiction (Substance Use Disorder) Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209945600000",
"number": "1447425517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4611 SCARLET SAGE DR",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810011019",
"telephone_number": "719-566-8075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 CENTRAL MAIN ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810034212",
"telephone_number": "719-583-4308",
"fax_number": "719-583-4375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRERA",
"first_name": "STACY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-29",
"last_updated": "2008-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "163WA0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "130777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.