Active NPI
Eloise Olivares
- Licensed Practical Nurse
- Pueblo, CO
National Provider Identifier
1811445083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN0025621
- Practice address
- 5055 Outlook Blvd
Pueblo, CO 81008-1388 - Phone
- (719) 568-9848
- NPI assigned
- Sep 16, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN0025621 | CO | Primary |
Addresses
Primary practice location
5055 Outlook Blvd
Pueblo, CO 81008-1388
Mailing address
PO Box 1268
Canon City, CO 81215-1268
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN0025621 | CO | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473984000000",
"number": "1811445083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1268",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812151268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5055 OUTLOOK BLVD",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810081388",
"telephone_number": "719-568-9848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVARES",
"first_name": "ELOISE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-16",
"last_updated": "2016-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "CO",
"license": "PN0025621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.