Provider Demographics
NPI:1083169494
Name:ALIABADI, KELSEY (NP)
Entity Type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:
Last Name:ALIABADI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 E HARMONY RD UNIT 330
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3403
Mailing Address - Country:US
Mailing Address - Phone:970-221-5878
Mailing Address - Fax:970-221-3564
Practice Address - Street 1:2121 E HARMONY RD UNIT 330
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3403
Practice Address - Country:US
Practice Address - Phone:970-221-5878
Practice Address - Fax:970-221-3564
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0202739163W00000X
COAPN.0992668-NP363L00000X, 363LA2200X, 363LG0600X, 363LF0000X, 364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily