Provider Demographics
NPI:1164902144
Name:UHL, ELISSA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELISSA
Middle Name:
Last Name:UHL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12850 E MONTVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2605
Mailing Address - Country:US
Mailing Address - Phone:303-724-2882
Mailing Address - Fax:
Practice Address - Street 1:65 TEJON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-1221
Practice Address - Country:US
Practice Address - Phone:303-778-3398
Practice Address - Fax:303-778-2774
Is Sole Proprietor?:No
Enumeration Date:2018-08-18
Last Update Date:2018-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0022343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0022343OtherPHARMACIST LICENSE