Healthcare Provider Details

I. General information

NPI: 1750623419
Provider Name (Legal Business Name): ELINOR JOYCE OBUCKLEY MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8758 WOLFF CT STE 205
WESTMINSTER CO
80031-6904
US

IV. Provider business mailing address

15928 ST PAUL ST
THORNTON CO
80602-7814
US

V. Phone/Fax

Practice location:
  • Phone: 303-797-9440
  • Fax: 303-797-9348
Mailing address:
  • Phone: 607-242-3305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number1619580
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1000387
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: