Provider Demographics
NPI:1174913602
Name:REILLY, KERRI ANN (FNP-C)
Entity type:Individual
Prefix:MS
First Name:KERRI
Middle Name:ANN
Last Name:REILLY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:KERRI
Other - Middle Name:ANN
Other - Last Name:ROUZE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:11891 MEADE CT.
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031
Mailing Address - Country:US
Mailing Address - Phone:303-469-3358
Mailing Address - Fax:
Practice Address - Street 1:10593 LOWELL DR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-1920
Practice Address - Country:US
Practice Address - Phone:303-469-3358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-04
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991620-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily