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Individual

MARIA KELLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2121 E HARMONY RD UNIT 100, FORT COLLINS, CO 80528-3401
(970) 221-1000
(970) 297-6844
Mailing address
2121 E HARMONY RD UNIT 100, FORT COLLINS, CO 80528-3401
(970) 221-1000
(970) 297-6844

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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