Healthcare Provider Details

I. General information

NPI: 1770809220
Provider Name (Legal Business Name): KENNA BROOKE BARBER ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2010
Last Update Date: 04/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 ZENOBIA ST
DENVER CO
80212-2235
US

IV. Provider business mailing address

4131 ZENOBIA ST
DENVER CO
80212-2235
US

V. Phone/Fax

Practice location:
  • Phone: 720-675-9355
  • Fax: 303-455-0729
Mailing address:
  • Phone: 720-675-9355
  • Fax: 303-455-0729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number09-1109
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: