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General NPI Number Information
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NPI Number | 1871869057
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Entity Type | Individual
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Provider Name | KELLY MARIE EVANS-HULLINGER MD
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Gender | Female
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Dates
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Enumeration Date | 04/01/2012
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Last Update Date | 08/13/2015
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Provider Practice Location Address
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Address Line | 1721 E 19TH AVE STE 520
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City | DENVER
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State | CO
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Zip | 80218-1243
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Country | US
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Telephone | 720-754-8134
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Fax | 303-869-2258
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Provider Business Mailing Address
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Address Line | 4900 S MONACO ST #210
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City | DENVER
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State | CO
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Zip | 80237-3486
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Country | US
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Telephone | 720-754-8134
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Fax | 303-869-2258
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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.0055106
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License Number State | CO
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