Healthcare Provider Details

I. General information

NPI: 1487792164
Provider Name (Legal Business Name): SONDRA ELAINE EARLY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 09/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2312 N NEVADA AVE STE 305
COLORADO SPRINGS CO
80907-5318
US

IV. Provider business mailing address

5803 LOCKHEED AVE STE 200
LOVELAND CO
80538-7027
US

V. Phone/Fax

Practice location:
  • Phone: 970-221-9451
  • Fax: 855-856-6479
Mailing address:
  • Phone: 970-221-9451
  • Fax: 855-856-6479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA18302
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: