Healthcare Provider Details

I. General information

NPI: 1821302423
Provider Name (Legal Business Name): KELLEY TOGIOLA NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2010
Last Update Date: 11/25/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER CMR 402
APO AE
09180-0000
US

IV. Provider business mailing address

LANDSTUHL REGIONAL MEDICAL CENTER CMR 402
APO AE
09180-0000
US

V. Phone/Fax

Practice location:
  • Phone: 637-186-8590
  • Fax:
Mailing address:
  • Phone: 637-186-8590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number129079
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0129079
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: