Individual
ELIZABETH ELLEN SKELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
902 LAKEVIEW AVE, PUEBLO, CO 81004-3597
(719) 557-5855
(719) 557-4652
Mailing address
902 LAKEVIEW AVE, PUEBLO, CO 81004-3597
(719) 557-5855
(719) 557-4652
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0992400
CO
363LF0000X
Family Nurse Practitioner
209008690
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209008690
ILLINOIS LICENSE
IL
Enumeration date
10/13/2011
Last updated
09/15/2020
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