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General NPI Number Information
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NPI Number | 1245408111
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Entity Type | Individual
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Provider Name | KELLEY G ROGERS NP
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Gender | Female
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 2525 ARAPAHOE AVE STE 200
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City | BOULDER
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State | CO
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Zip | 80302-6720
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Country | US
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Telephone | 303-447-1040
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Fax | 303-447-2882
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Provider Business Mailing Address
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Address Line | 701 SAN MATEO BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-1434
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Country | US
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Telephone | 52-659-5115
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Fax | 505-268-4350
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN.1634529
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APN.0992120-NP
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License Number State | CO
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