Individual
HEATHER KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3701 S BROADWAY, ENGLEWOOD, CO 80113-3611
(303) 761-1977
Mailing address
3701 S BROADWAY, ENGLEWOOD, CO 80113-3611
(303) 761-1977
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-990190
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42151244
—
CO
Enumeration date
09/12/2011
Last updated
09/25/2012
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