Provider Demographics
NPI:1942531512
Name:ECKERSON, SHEILA ANN
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:ANN
Last Name:ECKERSON
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 1:4828 FLICKER DR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81008-2814
Mailing Address - Country:US
Mailing Address - Phone:719-248-1441
Mailing Address - Fax:
Practice Address - Street 1:4828 FLICKER DR
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2814
Practice Address - Country:US
Practice Address - Phone:719-248-1441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO115482163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse