Provider Demographics
NPI:1922345537
Name:WEDELL, KARI A (NP)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:A
Last Name:WEDELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:A
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3333 S BANNOCK ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-2432
Mailing Address - Country:US
Mailing Address - Phone:303-957-1310
Mailing Address - Fax:303-761-4252
Practice Address - Street 1:2777 MILE HIGH STADIUM CIR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5222
Practice Address - Country:US
Practice Address - Phone:303-825-8822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0990607-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO51784513Medicaid
CO51784513Medicaid