Provider Demographics
NPI:1700961455
Name:CONNELL, ELISABETH ARMSTRONG (PNP)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:ARMSTRONG
Last Name:CONNELL
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:303-493-7000
Mailing Address - Fax:
Practice Address - Street 1:1601 E. 19TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1291
Practice Address - Country:US
Practice Address - Phone:303-839-6001
Practice Address - Fax:303-839-6033
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0004788363LP0200X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04901363OtherMEDICAID GROUP NUMBER
CO33107076Medicaid
CO37402552OtherMEDICAID GROUP NUMBER
804378Medicare ID - Type Unspecified
CO33107076Medicaid