1871739847 NPI number — SHEENA ELSPET CHAND P.A.

Table of content: SHEENA ELSPET CHAND P.A. (NPI 1871739847)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871739847 NPI number — SHEENA ELSPET CHAND P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAND
Provider First Name:
SHEENA
Provider Middle Name:
ELSPET
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHAPMAN
Provider Other First Name:
SHEENA
Provider Other Middle Name:
ELSPET
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1871739847
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
361 SECOND AVE SUITE 101
Provider Second Line Business Mailing Address:
P.O. BOX 1086
Provider Business Mailing Address City Name:
NIWOT
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80544
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-652-9222
Provider Business Mailing Address Fax Number:
303-652-9333

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
361 SECOND AVE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
NIWOT
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80544
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-652-9222
Provider Business Practice Location Address Fax Number:
303-652-9333
Provider Enumeration Date:
12/22/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  PA20027 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AM0700X , with the licence number: PA0003560 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 30923018 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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