| Doctor Name: | KELLI L SCOTT |
| NPI Number: | 1104896448 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 01042 |
| Business Practice Address: | 350 Lyckman Pl Fountain, CO - 808172861 |
| Business Phone Number: | 7196325700 |
| Business Fax Number: | |
| Mailing Address: | 3205 N Academy Blvd, Suite 130 COLORADO SPRINGS |
| State: | CO |
| Postal Code: | 809175147 |
| Phone Number: | 7196325700 |
| Fax Number: | |
| NPI Enumeration Date: | 01/26/2006 |
| NPI Last Update Date: | 11/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 01042 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |