Organization
GREELEY INTERNAL MEDICINE & NEPHROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNAE KELLY (OFFICE MANAGER)
(970) 304-0010
Entity
Organization
Contact information
Practice address
900 14TH ST, GREELEY, CO 80631-4622
(970) 304-0010
Mailing address
900 14TH ST, GREELEY, CO 80631-4622
(970) 304-0010
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31120
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127588
—
CO
Enumeration date
12/07/2007
Last updated
05/13/2008
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