Susan Jean Kelly, R.N.

Individual provider Active NPI Community Health Registered Nurse · Hugo, CO

NPI 1326313446 · NPPES record last updated Aug 1, 2013

Key facts

NPI
1326313446
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
63693 (CO)
Practice address
326 8TH Street
Hugo, CO 80821
Phone
(719) 743-2526
NPI assigned
Mar 22, 2012
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
63693COMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln County Public Health Past Accepting new patients
County of Lincoln Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 63693 CO Yes

Addresses

Primary practice location

326 8TH Street
Hugo, CO 80821

Mailing address

P.O. Box 125
326 8TH Street
Hugo, CO 80821
Phone (719) 743-2526

Other identifiers

IdentifierTypeStateIssuer
1013048495OtherCONPPES

Other providers in Hugo, CO

All providers in Hugo, CO · Community Health Registered Nurse in Colorado

Sources for this page

Verify at the official NPI Registry.