Healthcare Provider Details

I. General information

NPI: 1073432852
Provider Name (Legal Business Name): LAURA ELIZABETH KELLY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 WHEELING ST
AURORA CO
80045-7211
US

IV. Provider business mailing address

9138 E NASSAU AVE
DENVER CO
80237-1919
US

V. Phone/Fax

Practice location:
  • Phone: 720-723-6349
  • Fax:
Mailing address:
  • Phone: 804-908-1080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License Number0001250072
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: