Individual
MAUREEN E KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4491 BENT BROTHERS BLVD., COLORADO CITY, CO 81019-9990
(719) 595-7525
(719) 595-7965
Mailing address
PO BOX 560825, DENVER, CO 80256-0825
(719) 595-7580
(719) 545-0176
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
45238
CO
207R00000X
Internal Medicine Physician
88 214
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27064
—
NM
05
—
46323040
—
CO
Enumeration date
12/21/2005
Last updated
02/17/2016
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