Individual
MARISSA KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4851 INDEPENDENCE ST, WHEAT RIDGE, CO 80033-6715
(303) 425-0300
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
234499
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN.0998394-NP
CO
Other
Enumeration date
08/04/2020
Last updated
03/09/2023
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