Healthcare Provider Details

I. General information

NPI: 1942884507
Provider Name (Legal Business Name): KELLY ELIZABETH SCHMIDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S COLORADO BLVD STE 530
DENVER CO
80246-1255
US

IV. Provider business mailing address

2674 S KRAMERIA ST
DENVER CO
80222-7104
US

V. Phone/Fax

Practice location:
  • Phone: 720-316-0265
  • Fax:
Mailing address:
  • Phone: 718-440-6390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1001038
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: