Provider Demographics
NPI:1285860031
Name:DUNN, KELLI L (RN)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:L
Last Name:DUNN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 S KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-1086
Mailing Address - Country:US
Mailing Address - Phone:303-818-1157
Mailing Address - Fax:
Practice Address - Street 1:260 S KIPLING ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1086
Practice Address - Country:US
Practice Address - Phone:303-818-1157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103555163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse