Provider Demographics
NPI:1922366616
Name:WESTOVER, ELLIE A (DO)
Entity Type:Individual
Prefix:DR
First Name:ELLIE
Middle Name:A
Last Name:WESTOVER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 LADY MOON DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-4426
Mailing Address - Country:US
Mailing Address - Phone:708-214-5009
Mailing Address - Fax:
Practice Address - Street 1:4700 LADY MOON DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-4426
Practice Address - Country:US
Practice Address - Phone:970-821-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO56109207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO56109OtherLICENSE