Provider Demographics
NPI:1790877637
Name:PARCELL, KELLY JACOBS (ND)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:JACOBS
Last Name:PARCELL
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 28TH ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1030
Mailing Address - Country:US
Mailing Address - Phone:303-884-7557
Mailing Address - Fax:
Practice Address - Street 1:1440 28TH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1030
Practice Address - Country:US
Practice Address - Phone:303-884-7557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1019175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath