Healthcare Provider Details

I. General information

NPI: 1730249103
Provider Name (Legal Business Name): KAREN L VORDERBERG CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN L. KENDREGAN CNM

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 61ST AVE
GREELEY CO
80634-7989
US

IV. Provider business mailing address

1715 61ST AVE
GREELEY CO
80634-7989
US

V. Phone/Fax

Practice location:
  • Phone: 970-336-1500
  • Fax: 970-336-1505
Mailing address:
  • Phone: 970-336-1500
  • Fax: 970-336-1505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberWV101
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.0183477
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPN.0005437-CNM
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: