Provider Demographics
NPI:1194922658
Name:CAPPIELLO, EVA MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:MARIE
Last Name:CAPPIELLO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:M
Other - Last Name:CAPURRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-0130
Mailing Address - Country:US
Mailing Address - Phone:970-858-2186
Mailing Address - Fax:970-858-2208
Practice Address - Street 1:576 KOKOPELLI BLVD UNIT D-E
Practice Address - Street 2:
Practice Address - City:FRUITA
Practice Address - State:CO
Practice Address - Zip Code:81521-6304
Practice Address - Country:US
Practice Address - Phone:970-858-2590
Practice Address - Fax:970-858-5036
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0992830-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAE894ZMedicare PIN