Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0101246553 | VA |
N | 111NI0900X | Internist | 0101246553 | VA |
Y | 207R00000X | Internist | P5359 | TX |
Y | 111NI0900X | Internist | P5359 | TX |
N | 207RH0002X | Hospice and Palliative Medicine | DR.0062197 | CO |
NPI | 1275793226 |
---|---|
Provider Name | Dr. Kelly Patricia Ferraro |
First Address | Denver, CO 80204-4597 |
Second Address | Denver, CO 80204-4597 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 09/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
322694301 | (05) | TX |
322694302 | MEDICAID CSHCN (01) | TX |