Healthcare Provider Details

I. General information

NPI: 1760889349
Provider Name (Legal Business Name): PATRICIA LEE EELLS C.P.N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2014
Last Update Date: 01/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4125 BRIARGATE PKWY B520
COLORADO SPRINGS CO
80920
US

IV. Provider business mailing address

13123 E 16TH AVE # B395
AURORA CO
80045-7106
US

V. Phone/Fax

Practice location:
  • Phone: 719-305-9070
  • Fax: 719-305-9071
Mailing address:
  • Phone: 719-305-9070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.0094134
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPN.0001485-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: