Healthcare Provider Details

I. General information

NPI: 1356693188
Provider Name (Legal Business Name): CHELSEA LAUREN KISSINGER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2012
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 POTOMAC ST STE A
AURORA CO
80011-6845
US

IV. Provider business mailing address

3701 S BROADWAY
ENGLEWOOD CO
80113-3611
US

V. Phone/Fax

Practice location:
  • Phone: 303-360-6276
  • Fax: 303-360-3713
Mailing address:
  • Phone: 303-360-6276
  • Fax: 303-467-5350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1644965
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN198963
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0993067-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: