Provider Demographics
NPI:1982488797
Name:EHIZUELEN, EVELYN A (APN)
Entity Type:Individual
Prefix:MISS
First Name:EVELYN
Middle Name:A
Last Name:EHIZUELEN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MISS
Other - First Name:EVELYN
Other - Middle Name:A
Other - Last Name:EHIZUELEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:17801 E LEHIGH PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-3418
Mailing Address - Country:US
Mailing Address - Phone:303-875-1664
Mailing Address - Fax:
Practice Address - Street 1:17801 E LEHIGH PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-3418
Practice Address - Country:US
Practice Address - Phone:303-875-1664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0999027363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care