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General NPI Number Information
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NPI Number | 1417126269
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Entity Type | Individual
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Provider Name | KELLEE FITZGERALD CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 01/09/2018
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Provider Practice Location Address
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Address Line | 1400 E BOULDER ST STE 2508
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-5533
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Country | US
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Telephone | 719-365-6999
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Fax | 719-365-2837
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Provider Business Mailing Address
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Address Line | 1400 E BOULDER ST STE 2508
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-5533
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Country | US
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Telephone | 719-365-6999
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Fax | 719-365-2837
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.0128839
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APN.0100009
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License Number State | CO
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