Sandberg, Kelly Lynn
Sandberg, Kelly Lynn is an individual health care provider with primary practice located at 1400 E Boulder St , Colorado Springs CO 80909-5533. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Community Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Sandberg, Kelly Lynn can be contacted via phone (719) 365-5000.Contact Information
Primary practice address
1400 E Boulder St
Colorado Springs CO 80909-5533
Phone: (719) 365-5000
Fax: (303) 306-7753
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Community Health | 363LC1500X | 0990636 | Colorado |
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | APN.0990636-NP | Colorado |
Profile Details
NPI number | 1538408729 |
---|---|
LBN Legal business name | Sandberg, Kelly Lynn |
Credentials | Nurse Practitioner (NP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 7th, 2013 |
Last updated | Mar 17th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1538408729 | NPPES |
Colorado | MEDICAID | 34834320 |
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