Individual
KELLY SUE BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6041 S SYRACUSE WAY, SUITE 220, GREENWOOD VILLAGE, CO 80111-0000
(720) 482-1988
(720) 482-1990
Mailing address
1655 GLEN MOOR PKWY, LAKEWOOD, CO 80215-3039
(720) 252-8932
(720) 482-7990
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
111614
CO
Other
Enumeration date
05/21/2009
Last updated
12/17/2015
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