MEDICARE: MS. JULIANNA MARIE KENT

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	374J00000X	Doula		CO

General Provider Information

NPI Number	:	1952972622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIANNA MARIE KENT

Provider Business Mailing Address
First Line	:	3045 LONE FEATHER DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80929-9703
Country	:	US
Telephone Number	:	719-627-0744
Fax Number	:

Provider Business Practice Location Address
First Line	:	3045 LONE FEATHER DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80929-9703
Country	:	US
Telephone Number	:	719-627-0744
Fax Number	:

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

Provider Enumeration Date	:	07/05/2021
Last Update Date	:	07/05/2021

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