Individual
MARIA KELLEY
Active
Individual
MARIA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0198115
CO
363LF0000X
Family Nurse Practitioner
APN.0992709-NP
CO
363LG0600X
Gerontology Nurse Practitioner
Primary
APN.0992709-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CO
Enumeration date
09/28/2016
Last updated
11/07/2016
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