Individual
MARY ANNE M EAGELSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5257 S WADSWORTH BLVD, LITTLETON, CO 80123-2228
(303) 338-4545
Mailing address
5257 S WADSWORTH BLVD, LITTLETON, CO 80123-2228
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
124083
CO
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
2967
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014791
KAISER COMMERCIAL NUMBER
CO
05
—
84205369
—
CO
Enumeration date
02/27/2007
Last updated
05/21/2012
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