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:
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Health care specialties

SpecialtyCodeLicense #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 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538408729 NPPES
Colorado MEDICAID 34834320

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