Basic Information
| Provider Information | |||||||||
| NPI: | 1336402718 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEBSTER | ||||||||
| FirstName: | KELLY | ||||||||
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| Credential: | AGACNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 850 E HARVARD AVE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802105073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033064321 | ||||||||
| FaxNumber: | 3033064338 | ||||||||
| Practice Location | |||||||||
| Address1: | 850 E HARVARD AVE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802105073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033064321 | ||||||||
| FaxNumber: | 3033064338 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2012 | ||||||||
| LastUpdateDate: | 07/22/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | 179852 | CO | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine | 363LA2100X | APN.0992739-NP | CO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363L00000X | APN.0992739-NP | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.