Provider Demographics
NPI:1851061428
Name:BUKOWSKI, KELSEY LINN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:LINN
Last Name:BUKOWSKI
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 1:6085 BAY MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-8073
Mailing Address - Country:US
Mailing Address - Phone:970-593-2659
Mailing Address - Fax:
Practice Address - Street 1:2889 N GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-3247
Practice Address - Country:US
Practice Address - Phone:970-744-2866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996748-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily