Organization
PEDIATRIC EFFECTIVE ELIMINATION PROGRAM CLINIC & CONSULTING, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE LYNN MCGARRY MSN RN CPNP CUNP (DIRECTOR, PRESIDENT)
(720) 771-1135
Entity
Organization
Contact information
Practice address
6179 S BALSAM WAY, #205, LITTLETON, CO 80123-3091
(720) 771-1135
(303) 889-5247
Mailing address
9249 S BROADWAY, #200-268, HIGHLANDS RANCH, CO 80129-5690
(720) 771-1135
(303) 889-5247
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
88483
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15729362
—
CO
Enumeration date
07/26/2012
Last updated
09/07/2014
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