Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 0995214 | CO |
NPI | 1003452137 |
---|---|
Provider Name | Mrs. Elisha Elizabeth Mcguire |
First Address | Evergreen, CO 80439-7462 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2019 |
Last Update Date | 29/01/2020 |