MEDICARE: ROSEMARY KELLY RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN.0177624	CO

General Provider Information

NPI Number	:	1528945862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARY KELLY RN

Provider Business Mailing Address
First Line	:	9356 QUINTERO ST
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-7203
Country	:	US
Telephone Number	:	720-695-8388
Fax Number	:

Provider Business Practice Location Address
First Line	:	9356 QUINTERO ST
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-7203
Country	:	US
Telephone Number	:	720-695-8388
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	08/19/2025

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