Provider Demographics
NPI:1215442397
Name:PEARL, TOLOA (NP)
Entity type:Individual
Prefix:
First Name:TOLOA
Middle Name:
Last Name:PEARL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TOLOA
Other - Middle Name:E
Other - Last Name:PEARL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:501 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:CO
Mailing Address - Zip Code:81226-1126
Mailing Address - Country:US
Mailing Address - Phone:719-784-4816
Mailing Address - Fax:719-784-6014
Practice Address - Street 1:501 W 5TH ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:CO
Practice Address - Zip Code:81226-1126
Practice Address - Country:US
Practice Address - Phone:719-784-4816
Practice Address - Fax:719-784-6014
Is Sole Proprietor?:No
Enumeration Date:2017-12-11
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0993574-NP363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology