Kelly, Heather

Kelly, Heather is an individual health care provider with primary practice located at 3701 S Broadway , Englewood CO 80113-3611. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kelly, Heather can be contacted via phone (303) 761-1977.

Contact Information

Primary practice address
3701 S Broadway Englewood CO 80113-3611
Phone: (303) 761-1977
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP-990190 Colorado

Profile Details

NPI number 1689956005
LBN Legal business name Kelly, Heather
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2011
Last updated Sep 25th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689956005 NPPES
Colorado MEDICAID 42151244

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