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General NPI Number Information
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NPI Number | 1043888464
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Entity Type | Individual
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Provider Name | EILEEN E NEALE PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/13/2021
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 90 HEALTH PARK DR STE 290
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City | LOUISVILLE
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State | CO
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Zip | 80027-9586
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Country | US
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Telephone | 303-439-8910
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Fax |
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Provider Business Mailing Address
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Address Line | 10280 W 55TH AVE
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City | ARVADA
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State | CO
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Zip | 80002-4931
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0007139
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA.0007139
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA.0007139
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License Number State | CO
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