KELLIE ANN DOUGLAS (NPI# 1063840171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063840171 |
| Entity Type | Individual |
| Full Name | KELLIE ANN DOUGLAS |
| Credential | CPNP-PC |
| Practice Address |
4545 E 9th Ave Ste 260 Denver CO 80220 |
| Mailing Address |
1805 Shea Center Dr Ste 301 Highlands Ranch CO 80129-2251 |
| Practice Telephone | (303) 320-7366 |
| Mailing Telephone | 3033572559 |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2018-06-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
5007234 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | NURSE PRACTITIONER - APN LICENSE | 993170 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9137 Ridgeline Blvd Ste 130, Highlands Ranch, CO 801292394 | 3034710221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821465964 | Kellie Douglas | Pharmacist | 700 N Main St, Marion, SC 29571-2518 | 2015-08-24 |
| Street Address |
4545 E 9TH AVE STE 260 |
| City | DENVER |
| State | CO |
| Zip Code | 80220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821483462 | Siwen Dong | Pediatrics | 4545 E 9th Ave Ste 260, Denver, CO 80220 | 2015-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053876748 | Woody Dental Pllc | Dentist | 5989 E Colfax Avenue, Denver, CO 80220 | 2019-02-06 |
| 1366961930 | Maita Angelica Thams | Case Manager/Care Coordinator | 4455 E. 12th Ave, Denver, CO 80220 | 2017-09-14 |
| 1962943837 | Rocky Mountain Therapy Ltd | Clinic/Center | 883 Jersey St, Denver, CO 80220 | 2017-03-13 |
| 1578019188 | Alfredo Guzman | Pharmacist | 1055 Cleremont, Denver, CO 80220 | 2016-09-01 |
| 1265802144 | Joseph Parker Morse | Case Manager/Care Coordinator | 4455 East 12th Avenue, Denver, CO 80220 | 2015-10-05 |
| 1104296789 | Eric Poissant | Physical Therapist | 4700 East Hale Parkway, #550, Denver, CO 80220 | 2015-09-25 |
| 1104292085 | Casey Lucarelli | Student in an Organized Health Care Education/Training Program | 4455 E. 12th Av., Mhcd, Denver, CO 80220 | 2015-08-14 |
| 1124414081 | Domenic Michael Terenzi | Hospitalist | 8001 E 11th Ave Unit 5210, Denver, CO 80220 | 2015-04-07 |
| 1730598566 | Jessica Nichole Heck | Pharmacist | 1055 Clermont Street (119), Denver Va Medical Center- Echcs, Denver, CO 80220 | 2014-08-06 |
| 1700211307 | Nichelle Gabriele Haskett | Case Manager/Care Coordinator | 4455 E. 12th Ave., Denver, CO 80220 | 2013-09-13 |
| Find all providers in zip 80220 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912543778 | Lauren Wollenzin | Nurse Practitioner | 3548 Dexter Ct, Denver, CO 80207-1050 | 2019-11-26 |
| 1083186407 | Megan Brady | Nurse Practitioner | 454 S Lafayette St, Denver, CO 80209-2501 | 2018-12-24 |
| 1477934982 | Mary Brugger | Nurse Practitioner | 3344 Decatur St, Denver, CO 80211-3240 | 2015-06-11 |
| 1073953246 | Patricia Lynne Cullen | Nurse Practitioner | 3333 Regis Blvd. (g-8), Denver, CO 80221-1099 | 2013-07-02 |
| 1730453549 | Bianca Mcclammy | Nurse Practitioner | 4545 East 9th Avenue, Suite 260, Denver, CO 80220 | 2012-02-27 |
| 1548550908 | Pediatric Effective Elimination Program Clinic & Consulting, PC | Nurse Practitioner | 999 18th Street, 3000, Denver, CO 80202 | 2011-04-19 |
| 1265754162 | Stacey L Bednarz | Nurse Practitioner | 4900 East Kentucky Ave, Denver, CO 80246 | 2010-02-18 |
| 1972770287 | Amy Ann Campbell | Nurse Practitioner | 4500 E 9th Ave Ste 300, Denver, CO 80220-3922 | 2008-05-15 |
| 1346330255 | Lynn Howe Gilbert | Nurse Practitioner | 3447 W 64th Ave, Denver, CO 80221-2163 | 2006-10-13 |
| 1780614750 | Kimberly A. Baumann | Nurse Practitioner | 635 N Nc 16 Business Hwy, Denver, NC 28037-7574 | 2006-07-04 |
| Find all providers in DENVER | ||||
Please comment or provide details below to improve the information on KELLIE ANN DOUGLAS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.