MEDICARE: MRS. MARY ELIZABETH ELLIOTT NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	125037	CO

General Provider Information

NPI Number	:	1144301649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY ELIZABETH ELLIOTT NP

Provider Business Mailing Address
First Line	:	674 CLERMONT ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-5024
Country	:	US
Telephone Number	:	303-722-9093
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 BROADWAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-2706
Country	:	US
Telephone Number	:	303-813-7735
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	07/08/2007

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