Provider Demographics
NPI:1225844616
Name:ORELLANA, KELLY SUE
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:SUE
Last Name:ORELLANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1076
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:CO
Mailing Address - Zip Code:81520-1076
Mailing Address - Country:US
Mailing Address - Phone:970-260-0115
Mailing Address - Fax:
Practice Address - Street 1:530 34 RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:CO
Practice Address - Zip Code:81520-9763
Practice Address - Country:US
Practice Address - Phone:970-260-0115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter