Individual
ELOISE OLIVARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5055 OUTLOOK BLVD, PUEBLO, CO 81008-1388
(719) 568-9848
Mailing address
PO BOX 1268, CANON CITY, CO 81215-1268
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN0025621
CO
Other
Enumeration date
09/16/2016
Last updated
09/16/2016
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