Provider Demographics
NPI:1477995280
Name:EYSER, JOETTE S (APN)
Entity Type:Individual
Prefix:MS
First Name:JOETTE
Middle Name:S
Last Name:EYSER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LEADVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80461-3836
Mailing Address - Country:US
Mailing Address - Phone:719-293-0858
Mailing Address - Fax:888-329-6432
Practice Address - Street 1:508 W 8TH ST
Practice Address - Street 2:
Practice Address - City:LEADVILLE
Practice Address - State:CO
Practice Address - Zip Code:80461-3836
Practice Address - Country:US
Practice Address - Phone:719-293-0858
Practice Address - Fax:888-329-6432
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-22
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0991268363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily