Healthcare Provider Details

I. General information

NPI: 1881534634
Provider Name (Legal Business Name): KENDI BURNETTE-PHELPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KENDI PHELPS

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 N NEVADA AVE
COLORADO SPRINGS CO
80907-6819
US

IV. Provider business mailing address

2222 N NEVADA AVE
COLORADO SPRINGS CO
80907-6819
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberTL.0011397
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: