Healthcare Provider Details

I. General information

NPI: 1053462895
Provider Name (Legal Business Name): ERIKA S KENNEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 W. 38TH AVE. SUITE 220
DENVER CO
80212-2107
US

IV. Provider business mailing address

4500 W. 38TH AVE. SUITE 220
DENVER CO
80212-2107
US

V. Phone/Fax

Practice location:
  • Phone: 303-420-1297
  • Fax: 303-420-2953
Mailing address:
  • Phone: 303-420-1297
  • Fax: 303-420-2953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number38298
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: