Provider Demographics
NPI:1457663189
Name:MCCARREL, ELIZABETH ANN
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:MCCARREL
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:PO BOX 1687
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-1687
Mailing Address - Country:US
Mailing Address - Phone:970-256-6322
Mailing Address - Fax:970-263-2691
Practice Address - Street 1:2373 G RD
Practice Address - Street 2:SUITE 240
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1002
Practice Address - Country:US
Practice Address - Phone:970-644-4400
Practice Address - Fax:970-263-2691
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0053924207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO43928773Medicaid