Provider Demographics
NPI:1972592657
Name:VELA BROL, MISAE UEHA (NP)
Entity Type:Individual
Prefix:
First Name:MISAE
Middle Name:UEHA
Last Name:VELA BROL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MISAE
Other - Middle Name:
Other - Last Name:UEHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8300 ALCOTT ST STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-4030
Mailing Address - Country:US
Mailing Address - Phone:720-443-8461
Mailing Address - Fax:
Practice Address - Street 1:8300 ALCOTT ST STE 300
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-4030
Practice Address - Country:US
Practice Address - Phone:720-443-8461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0004786-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO70588074Medicaid
C804209Medicare PIN
Q59031Medicare UPIN