Healthcare Provider Details

I. General information

NPI: 1508595059
Provider Name (Legal Business Name): KELSEY L BUNDY DNP- CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 E PROSPECT RD STE 160
FORT COLLINS CO
80525-9098
US

IV. Provider business mailing address

2620 E PROSPECT RD STE 160
FORT COLLINS CO
80525-9098
US

V. Phone/Fax

Practice location:
  • Phone: 970-221-4977
  • Fax: 970-221-4980
Mailing address:
  • Phone: 702-214-9779
  • Fax: 970-221-4980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberC-APN.0100866-C-CNM
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: