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Individual

AMANDA ELIZABETH KELLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C, ATC

Contact information

Practice address
4125 BRIARGATE PKWY, COLORADO SPRINGS, CO 80920-7804
(719) 305-9060
Mailing address
PO BOX 110429, AURORA, CO 80042-0429

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT.0002683
CO
363A00000X
Physician Assistant
PA.0008604
CO
363AM0700X
Medical Physician Assistant
Primary
PA.0008604
CO

Other

Enumeration date
07/14/2019
Last updated
01/30/2025
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