Provider Demographics
NPI:1861798894
Name:HAROLDSEN, ELISHA ANN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ELISHA
Middle Name:ANN
Last Name:HAROLDSEN
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1881 N 2070 W
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-4755
Mailing Address - Country:US
Mailing Address - Phone:801-891-1858
Mailing Address - Fax:435-688-0330
Practice Address - Street 1:1490 E FOREMASTER DR STE 260
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4502
Practice Address - Country:US
Practice Address - Phone:435-688-0156
Practice Address - Fax:435-622-0330
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2021-12-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT2855743-1260363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant