MEDICARE: KENDI BURNETTE-PHELPS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	TL.0011397	CO

General Provider Information

NPI Number	:	1881534634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDI BURNETTE-PHELPS

Provider Business Mailing Address
First Line	:	2222 N NEVADA AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-6819
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2222 N NEVADA AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-6819
Country	:	US
Telephone Number	:	719-776-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2026
Last Update Date	:	05/12/2026

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Directions to “ KENDI BURNETTE-PHELPS ” Practice Location

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