Provider Demographics
NPI:1326679549
Name:ESHELMAN, DANA ASHTON
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:ASHTON
Last Name:ESHELMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-3645
Mailing Address - Country:US
Mailing Address - Phone:714-393-7054
Mailing Address - Fax:
Practice Address - Street 1:651 MITCHELL WAY
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-8051
Practice Address - Country:US
Practice Address - Phone:714-393-7054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-27
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86065791