Healthcare Provider Details

I. General information

NPI: 1811135197
Provider Name (Legal Business Name): KELLY ANNE SCHLOESSER WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2009
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 CRYSTOLA STREET
CALHAN CO
80808
US

IV. Provider business mailing address

PO BOX 275
CALHAN CO
80808-0275
US

V. Phone/Fax

Practice location:
  • Phone: 719-347-0100
  • Fax: 719-347-0851
Mailing address:
  • Phone: 719-347-0100
  • Fax: 719-347-0851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number5945
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: