Kelli Susann Deeter, FNP-BC
Nurse Practitioner, Family in Greenwood Village, CO. Individual provider (NPI-1).
NPI number1366872004
StatusActive
Last updated in NPPESFeb 25, 2016
Details
- NPI
- 1366872004
- Entity type
- Individual (NPI-1)
- Name
- Kelli Susann Deeter
- Credential
- FNP-BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 15, 2013
- Last updated
- Feb 25, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 2013103096 | CO | Yes |
Practice location
6455 Yosemite St, 6th FloorGreenwood Village, CO 80111
Phone 303-692-1211 · Fax 844-434-0379
Mailing address
295 Martin DrBoulder, CO 80305-3442
Phone 970-389-5537
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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