Individual
ELISE CARNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1735 S PUBLIC RD STE 100, LAFAYETTE, CO 80026-7093
(303) 650-4460
Mailing address
40 S BOULDER CIR APT 4023, BOULDER, CO 80303-4262
(802) 922-8550
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0007463
CO
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2022
Last updated
07/13/2022
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