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General NPI Number Information
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NPI Number | 1306790951
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Entity Type | Individual
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Provider Name | TRAVIS AUSTIN KELLY
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Gender | Male
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 02/23/2026
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Provider Practice Location Address
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Address Line | 5495 ARAPAHOE AVE
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City | BOULDER
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State | CO
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Zip | 80303-1200
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Country | US
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Telephone | 303-544-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 9029 S YOSEMITE ST UNIT 2302
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City | LONE TREE
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State | CO
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Zip | 80124-2962
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Country | US
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Telephone |
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | CO
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