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General NPI Number Information
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NPI Number | 1417639246
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Entity Type | Individual
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Provider Name | KELLI MARIE GREEN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/02/2023
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 24300 E SMOKY HILL RD UNIT 120
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City | AURORA
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State | CO
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Zip | 80016-1387
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Country | US
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Telephone | 303-330-0410
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Fax | 303-330-0732
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Provider Business Mailing Address
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Address Line | 1805 SHEA CENTER DR STE 450
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-2255
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Country | US
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Telephone | 303-357-2559
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Fax | 303-330-0732
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0998755
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 299387
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License Number State | AZ
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