Healthcare Provider Details

I. General information

NPI: 1346222767
Provider Name (Legal Business Name): KELLY L MOWREY RN,MS, ANP-C, CNRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2005
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7780 S BROADWAY STE 350
LITTLETON CO
80122-2641
US

IV. Provider business mailing address

PO BOX 5693
DENVER CO
80217-5693
US

V. Phone/Fax

Practice location:
  • Phone: 720-638-7500
  • Fax: 720-583-6770
Mailing address:
  • Phone: 303-306-7783
  • Fax: 303-306-7753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberAPN.0004736-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPN.0004736-NP
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number140634
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0004736-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: