Healthcare Provider Details

I. General information

NPI: 1306309364
Provider Name (Legal Business Name): ALLIE KAY PRESTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 29TH ST FL 2
GREELEY CO
80634-5474
US

IV. Provider business mailing address

6767 29TH ST FL 2
GREELEY CO
80634-5474
US

V. Phone/Fax

Practice location:
  • Phone: 970-457-1955
  • Fax: 970-652-2733
Mailing address:
  • Phone: 970-457-1955
  • Fax: 970-652-2733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberU5794
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: