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Individual
MRS. KELLY MARIE SIDOR
Active
Individual
MRS. KELLY MARIE SIDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
0095414
CO
363LA2100X
Acute Care Nurse Practitioner
0995414
CO
363LA2100X
Acute Care Nurse Practitioner
209008917
IL
363LA2200X
Adult Health Nurse Practitioner
Primary
APN.0995414-NP
CO
Other
Enumeration date
09/27/2011
Last updated
04/23/2021
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