Individual
KELLI L SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
350 LYCKMAN PL, FOUNTAIN, CO 80817-2861
(719) 632-5700
Mailing address
3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917-5147
(719) 632-5700
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
01042
KS
363AM0700X
Medical Physician Assistant
Primary
3224
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
426914
BLUE CROSS/BLUE SHIELD
KS
01
—
461466
CHILDRENS MERCY FAMILY HP
KS
05
—
89773373
—
CO
Enumeration date
01/26/2006
Last updated
11/06/2015
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