Stacey Kowalski, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

1656519 Issued in CO

Practice address

2217 Champa St
Denver, CO 80205-2531

Phone

(720) 398-9666

NPI assigned

Sep 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacey Formwalt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1536364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536364800000",
    "number": "1487137261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 CHAMPA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 CHAMPA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052531",
            "telephone_number": "720-398-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "STACEY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-08",
        "last_updated": "2018-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "1656519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "FORMWALT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Darya Kovalchuk, RN
• Susanna Kovari, M.D.
• Jessica Kovats, PHARMD, MS
• Rachel Anne Kovensky, PH.D., L.P.
• Gregory R Kowalchuk, DDS
• Craig George Kozak, DC, PA-C, MSPAS
• Hannah Mary Koziol, DPT
• John J Kozlevchar, PA
• Zofia Kozlowska, MA, LAC, LPC
• Elizabeth Kozora, PHD

• Registered Nurse in Denver, CO
• Providers in Denver, CO by specialty
• Registered Nurse in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2018; 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.