Provider Demographics
NPI:1225234065
Name:ELP L.L.C
Entity type:Organization
Organization Name:ELP L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:DALENE
Authorized Official - Middle Name:D
Authorized Official - Last Name:PERDUE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:719-564-5855
Mailing Address - Street 1:47 LOYOLA LN
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005-1656
Mailing Address - Country:US
Mailing Address - Phone:719-564-5855
Mailing Address - Fax:
Practice Address - Street 1:4100 JERRY MURPHY RD
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-1046
Practice Address - Country:US
Practice Address - Phone:719-671-5564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO150270367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty