Eagelston, Mary Anne M

Eagelston, Mary Anne M is an individual health care provider with primary practice located at 5257 S Wadsworth Blvd , Littleton CO 80123-2228. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology. Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology is her primary health care specialty. Eagelston, Mary Anne M can be contacted via phone (303) 338-4545.

Contact Information

Primary practice address
5257 S Wadsworth Blvd Littleton CO 80123-2228
Phone: (303) 338-4545
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 124083 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X 2967 Colorado

Profile Details

NPI number 1316074347
LBN Legal business name Eagelston, Mary Anne M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2007
Last updated May 21st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316074347 NPPES
Colorado Other 014791 KAISER COMMERCIAL NUMBER
Colorado MEDICAID 84205369 KAISER COMMERCIAL NUMBER

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