Individual
MRS. KELLY J PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8550 W 38TH AVE, SUITE 205, WHEAT RIDGE, CO 80033-4300
(303) 467-8987
(303) 467-9510
Mailing address
8550 W 38TH AVE, SUITE 205, WHEATRIDGE, CO 80033
(303) 425-2797
(303) 467-9510
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2057
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AB01549
ANTHEM
CO
01
—
P00458106
MEDICARE RAILROAD
CO
Enumeration date
06/07/2006
Last updated
12/07/2011
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