Individual
DIANE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
940 CENTRAL PARK DR STE 101, STEAMBOAT SPRINGS, CO 80487-8816
(970) 879-1632
Mailing address
940 CENTRAL PARK DR 101, STEAMBOAT SPRINGS, CO 80487-8816
(970) 879-1632
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
179562
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
179526
NURSE LICENSE
CO
Enumeration date
06/24/2010
Last updated
06/24/2010
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