Provider Demographics
NPI:1467074823
Name:DEWAN, KAYLEE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:DEWAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14111 E ALAMEDA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2509
Mailing Address - Country:US
Mailing Address - Phone:303-343-1357
Mailing Address - Fax:
Practice Address - Street 1:14111 E ALAMEDA AVE STE 200
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2509
Practice Address - Country:US
Practice Address - Phone:303-343-1357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704324743363LF0000X
COAPN.0995460-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily