Healthcare Provider Details

I. General information

NPI: 1295130110
Provider Name (Legal Business Name): KELSEY SKILLAS HUNGER AG-ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2014
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ROCKY MOUNTAIN AVE STE 100
LOVELAND CO
80538-9004
US

IV. Provider business mailing address

6720 BERTNER AVE # MC2-114A
HOUSTON TX
77030-2604
US

V. Phone/Fax

Practice location:
  • Phone: 970-221-1000
  • Fax:
Mailing address:
  • Phone: 832-355-9635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP126681
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPN.0995178-NP
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number865432
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: