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NPI Code Detail

MEDICARE: KELLY O'CONNELL RN

MEDICARE: KELLY O'CONNELL 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
1163WX0003XInpatient Obstetric Registered Nurse1664812CO

General Provider Information

NPI Number : 1790615615
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY O'CONNELL RN
Provider Business Mailing Address
First Line : 4556 BRYANT ST
Second Line :
City : DENVER
State : CO
Zip : 80211-1457
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1600 PR CTR PKWY
Second Line :
City : BRIGHTON
State : CO
Zip : 80601-4006
Country : US
Telephone Number : 303-498-1600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2026
Last Update Date : 05/21/2026

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