Provider Demographics
NPI:1093112856
Name:STONE, KELLY (FNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:KRAUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2760 29TH ST. CO
Mailing Address - Street 2:STE 2B
Mailing Address - City:BOULDER,
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1221
Mailing Address - Country:US
Mailing Address - Phone:303-444-6400
Mailing Address - Fax:303-444-6465
Practice Address - Street 1:2760 29TH ST. CO
Practice Address - Street 2:STE 2B
Practice Address - City:BOULDER,
Practice Address - State:CO
Practice Address - Zip Code:80301-1221
Practice Address - Country:US
Practice Address - Phone:303-444-6400
Practice Address - Fax:303-444-6465
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991438-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily