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General NPI Number Information
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NPI Number | 1437733664
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Entity Type | Individual
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Provider Name | KELLI DEBORAH TICHY DO
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Gender | Female
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Dates
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Enumeration Date | 05/12/2021
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 835 E 18TH AVE
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City | DENVER
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State | CO
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Zip | 80218-1024
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Country | US
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Telephone | 303-798-8245
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Fax |
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Provider Business Mailing Address
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Address Line | 12332 N 4TH ST
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City | PARKER
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State | CO
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Zip | 80134-9656
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Country | US
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Telephone | 303-828-6059
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | DR.0074313
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License Number State | CO
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