Healthcare Provider Details

I. General information

NPI: 1477798619
Provider Name (Legal Business Name): HEATHER ANN KENDALL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2008
Last Update Date: 12/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10065 E HARVARD AVE
DENVER CO
80231-5968
US

IV. Provider business mailing address

6021 CASTLEGATE DR W APT E28
CASTLE ROCK CO
80108-3495
US

V. Phone/Fax

Practice location:
  • Phone: 303-367-2973
  • Fax:
Mailing address:
  • Phone: 720-733-1242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number129900
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: