MEDICARE: MRS. ELISABETH DURSTON CONNOR

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1174460869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELISABETH DURSTON CONNOR

Provider Business Mailing Address
First Line	:	2209 JULIAN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5026
Country	:	US
Telephone Number	:	240-418-0410
Fax Number	:

Provider Business Practice Location Address
First Line	:	2209 JULIAN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5026
Country	:	US
Telephone Number	:	240-418-0410
Fax Number	:

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

Provider Enumeration Date	:	04/30/2026
Last Update Date	:	04/30/2026

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