Healthcare Provider Details

I. General information

NPI: 1265664676
Provider Name (Legal Business Name): GLENNA E KERSTEN WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GLENNA SLOSS

II. Dates (important events)

Enumeration Date: 08/18/2009
Last Update Date: 08/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 E HAMPDEN AVE STE 350
ENGLEWOOD CO
80113-3877
US

IV. Provider business mailing address

499 E HAMPDEN AVE STE 350
ENGLEWOOD CO
80113-3877
US

V. Phone/Fax

Practice location:
  • Phone: 303-744-3477
  • Fax: 303-733-5848
Mailing address:
  • Phone: 303-744-3477
  • Fax: 303-733-5848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number10006
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: